Registration Form
2023-2024
Student Name
*
First Name
Last Name
Student Birthday
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
Pre -K
K
1
2
3
4
5
6
7
8
9
10
11
12
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother/Guardian Name
*
First Name
Last Name
Primary Guardian Cell
*
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Guardian Work
Please enter a valid phone number.
Format: (000) 000-0000.
Primary Guardian Email
*
example@example.com
Secondary Guardian Name
First Name
Last Name
Secondary Guardian Cell
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Guardian Work
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Guardian Email
example@example.com
Years of Dance Through 2023
*
What Classes are You Interested In
*
Mommy & Me
Preschool Combo
Preschool Gymnastics
Preschool Clogging
Technique
Tap
Jazz
Hiphop
Clogging
Ballet
Pointe
Classical Ballet
Gymnastics
Comments/Conflicts
Interested in Competition Info
*
Yes
No
Do you need to add a 2nd Student
*
Yes
No
Back
Next
2nd Students Name
*
First Name
Last Name
2nd Student Birthday
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
Pre -K
K
1
2
3
4
5
6
7
8
9
10
11
12
Years of Dance Through 2023
*
What Classes are You Interested In
*
Mommy & Me
Preschool Combo
Preschool Gymnastics
Preschool Clogging
Technique
Tap
Jazz
Hiphop
Clogging
Ballet
Pointe
Classical Ballet
Gymnastics
Comments/Conflicts
Interested in Competition Info
*
Yes
No
Do you need to add a 3rd Student
*
Yes
No
Back
Next
3rd Students Name
*
First Name
Last Name
3rd Student Birthday
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
Pre -K
K
1
2
3
4
5
6
7
8
9
10
11
12
Years of Dance Through 2023
*
What Classes are You Interested In
*
Mommy & Me
Preschool Combo
Preschool Gymnastics
Preschool Clogging
Technique
Tap
Jazz
Hiphop
Clogging
Ballet
Pointe
Classical Ballet
Gymnastics
Comments/Conflicts
Interested in Competition Info
*
Yes
No
Do you need to add a 4th Student
*
Yes
No
Back
Next
4th Students Name
*
First Name
Last Name
4th Student Birthday
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
Pre -K
K
1
2
3
4
5
6
7
8
9
10
11
12
Years of Dance Through 2023
*
What Classes are You Interested In
*
Mommy & Me
Preschool Combo
Preschool Gymnastics
Preschool Clogging
Technique
Tap
Jazz
Hiphop
Clogging
Ballet
Pointe
Classical Ballet
Gymnastics
Comments/Conflicts
Interested in Competition Info
*
Yes
No
Back
Next
My Products
*
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Registration Fee 2023-24
Registration Fee 2022-23 (Only one per family)
$
50.00
Credit Card
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