Parent Form -ZOOM/LIVE Dance Class Registration

Parent Form - ZOOM/LIVE Dance Class Registration

This form is for parent registration for participating student(s). All sessions are 6 Weeks in length at $100 per student participant.

Parent Information
Parent Name*

First NameLast Name
Parent E-mail*
Parent Phone*

Area CodePhone Number
Student Name*

First NameLast Name
Student Age*
Additional Student

First NameLast Name
Additional Student Age
Virtual Dance Fee
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Virtual Zoom Preschool Dance 6 Weeks Session (Includes $3.30 Processing Fee)$103.30
This fee is per student and must match the student names above. This fee is for 6 Weeks of Dance, Tiny Dancer Activity Book, & Dance Medal Award

Number of Participating Student(s)

Total $0.00
Promotional Use:

Parent/Guardian Agreement As the Parent/Guardian I am committing to Dazzle’s Mission and Developmental Movement program for my child or children. I understand that my child’s participation in this program is important to his or her overall growth and development. I give full consent and understand that my child’s picture/video may be used in promotional material.
This form and payment will need to be completed at least 3 days before classes begin so all Zoom links can be sent for LIVE classes.
Parent Signature of Consent & Particpation

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