2024-2025 Massey School of Dance Registration Form
**Once form is submitted a request for payment for the Registration Fee of $40 (Non refundable) will be sent.**
Dancer's Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date
Dancer's Phone Number
-
Area Code
Phone Number
Dancer's Name (sibling #2)
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Dancer's Phone Number
-
Area Code
Phone Number
Dancer's Name (sibling #3)
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Parent's Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Parent's Name
*
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
*
example@example.com
Mother's Occupation
Father's Occupation
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School
School Grade as of Sept. 2024
Classes interested in
Ballet
TLC-Turns, Leaps, Conditioning (Recommended for intermediate/advanced students)
Tap
Tap/Ballet Combo (Recommended for ages 2.5-5 years of age.)
Jazz
ACRO
Lyrical
Hip Hop
Clogging
Pointe
Mommy & Me
2 year old Baby Ballet/Creative Movement Class (5 Week Session)
Adult Classes
Please let us know if you are interested in any of the following Competition Teams (Audition Only- Auditions held in May):
Competition Prep (ages 4-5)
Mini Troupe (ages 5-7)
PeeWee (ages 8-10)
Junior Troupe (ages 11-14)
Senior Troupe (ages 15-18)
Clogging Team (ages 9-18)
Hip Hop Competition Team (ages 9-18)
How did you hear about us?
Returning Dancer
Social Media
Family or Friend
Web search
Other
Previous Training
(Please include type of dance and age started.)
Number of Years with Massey
Number of Years with another Dance School
Earliest possible class time
Please list any allergies or medical conditions your child has that we need to be aware of
*
Emergency Contact
First Name
Last Name
Emergency Contact Number
-
Area Code
Phone Number
Submit
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