Dance Classes Registration

Dance Classes Registration Form

All students must register prior to dance class and performance participation.
Name

First NameLast Name
Date of birth

MonthDayYear
Date
Gender

MaleFemale
Parent/Guardian Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Relationship to Student
Phone Number
Please enter a valid phone number.
Preferred Dance Style

BalletJazzHip HopContemporaryTapOther
Level of Experience

BeginnerIntermediateAdvanced
Medical Conditions or Allergies
How did you hear about us?

Word of MouthWebsiteSocial MediaFlyerOther
Terms and Conditions:

By submitting this form, I acknowledge that participation in dance classes involves physical activity and I hereby release the dance studio and its instructors from any liability for injuries or accidents that may occur during classes or events.
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Date signed

MonthDayYear
Date
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Dance Classes Registration Form