Language
English (US)
Spanish (Latin America)
Summer 2025: August Back-to-School Week & Pointe Intensive
Dance Registration
Dancer's Name
*
First Name
Last Name
Dancer's Date of Birth
*
-
Month
-
Day
Year
Date
Dancer's Age
*
Dancer's Grade
*
Parent/Guardian Name
*
First Name
Last Name
Email
*
Secondary Parent/Guardian Email
*
example@example.com
Phone
*
222-333-4444
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone
*
222-333-4444
Primary Physician Name
*
First Name
Last Name
Physician Phone
*
222-333-4444
Comments or Medical Concerns
Any notes or context you want to add
REFUND POLICY: Tuition assistance scholarships or refunds for any reason are not available for our summer classes.
*
I acknowledge that I have read, understand and will abide by the refund policy stated above.
The Palm Theatre and Palm Arts, Inc. IS NOT RESPONSIBLE FOR INJURIES ON THE PREMISES. By clicking below, I acknowledge that dance, like any physical activity, can result in injury and therefore, I will not hold the Palm Theatre or Palm Arts, Inc., associated staff, and/or advisory board members liable for injuries incurred during class or on the premises. I also understand that a teacher may have physical contact with a student in order to correct posture and proper placement. I consent to the use of photos, images, videos of my child taken during classes or performances to be used for educational or marketing purposes on the Palm Theatre and Palm Arts, Inc. website and/or printed materials, social media, videos without review or compensation.
*
I acknowledge that I have read, understand and will abide by the policies stated above.
My Products
prev
next
( X )
Back-to-School Dance Week | Middle & High School
$
80.00
5 – 6:15pm | 8/25 - 8/28 | Studio 145
Beginner Pointe Intensive (teacher permission required / MUST also enroll in Back-to-School Dance Week)
$
80.00
4-5pm | 8/25 - 8/28 | Studio 145
Total
$
0.00
Credit Card
Submit
Should be Empty: