Pre Registration Form

Pre Registration Form
2026-2027 School Year

A separate form must be received for each student.
Date

MonthDayYear
Date
Student Name*

First NameLast Name
Birth Date*

MonthDayYear
Age*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Alternate Number
Format: (000) 000-0000.
Years of Dance Training Completed
Year First Attended Dance School
BalletTapJazzLyricalModernHip HopOther
From a friendFacebookInstagramOur SignReturningOther
Academic School Attending In The Fall
Grade
Preferred Dance Class Days/Times For Classes Beginning in September
Mother's Name

First NameLast Name
Father's Name

First NameLast Name
Occupation
Occupation
Employer's Name
Employer's Name
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Work Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact - Who should we contact in case of emergency?
Phone (If different from above)
Please enter a valid phone number.Format: (000) 000-0000.
I have read, understand, and agree to the studio’s policies and procedures listed in the policy agreement. I have carefully read the liability release and understand its content and significance. I agree to abide by the studio's policies and nearby grant consent.
Signature*

Powered by Jotform SignClear
Should be Empty:

2026-2027 School Year