Rawcade Registration Form

Registration Form

Fill out the form carefully & completely for registration
Performer's Name*

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian

First NameLast Name
Parent/Guardian E-mail*
example@example.com
Mobile Number*
Occupation
Work Number
Please enter a valid phone number.
How would you like to train?

Mobile (we come to you)In Studio (you come to us)Hybrid (both in studio & mobile)
How many times a week would you like to train?

Novice - light growth: 1x per weekIntermediate- visual growth: 2x per weekAvid - heavy growth: 3x/weekPro - consistent visual growth: 4x/week
Preferred Discipline*
Select from the dropdown a preferred dance style. May select up to 3
Desired Start Date*

MonthDayYear
Date
Previous Dance Training or Additional Comments

0/360
Media Release: May we take photos/videos during training for promotional purposes?

Yes — I grant permissionNo — please do not use media of me/my child
Signature Acknowledgement (Required checkbox)above.

By checking this box, I certify the information provided is correct, and I agree to the terms listed
Client or Parent/Guardian Signature*

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Today's Date

MonthDayYear
Date

Registration Form