Rosedale Valley Dance Registration

Rosedale Valley Dance Registration

2025 / 2026 Season
Birth Date*

MonthDayYear
Date
Student Name*

First NameLast Name
Age of Student (as of Dec 31, 2025)*
Grade*
Parent / Guardian (1)*

First NameLast Name
Parent / Guardian (2)

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone Number

Area CodePhone Number
Cell Number - Parent / Guardian (1)*

Area CodePhone Number
Phone Number - Parent / Guardian (2)

Area CodePhone Number
Email Address - Parent / Guardian (1)*
example@example.com
Email Address - Parent / Guardian (2)
example@example.com
*Please Note Any Learning or Physical Disabilities:*
Please Note if this is your child's 5th, 10th or 15th year with our studio

5th Year10th Year15th Year
Years of Dance Experience*
Interested in Extra Projects? (for dancers with 5+ years experience / teachers decision)

SoloDuetOther
Types of Dance Student Wishes To Take This Year*

BALLET/TAP COMBO CLASS (Preschool to Intermediate)ACRO/JAZZ COMBO CLASS (Primary/Junior/Intermediate)HIP HOP (Preschool Level +)MUSICAL THEATRE (Primary to Teen)BOY'S HIP HOP (Ages 9-13)BALLET (Preteen, Teen, Intermediate)TAP (Intermediate/Preteen / Teen)JAZZ (Intermediate/Preteen / Teen)LYRICAL (Intermediate / Preteen /Teen)CONTEMPORARY (Teen)TECHNIQUE (Mandatory for BALLET, JAZZ, LYRICAL, ACRO, and CONTEMPORARY)ADULT ALUMNI (JAZZ/CONTEMPORARY)
I, First Name* Last Name* (Parent / Guardian) hereby give my consent to allow pictures of my child First Name* Last Name* (dancer's name) to be displayed as part of our studio's promotion (i.e. Website, in studio, recital displays, etc.)
Signature*

Clear
Signature Date*

MonthDayYear
Date
REGISTRATION FEE: $35 payable to Rosedale Valley Dance at time of registration.*

PaidNot Paid
Additional dancers in same family pay $15 each.
NOTE:

Costume fees must be paid separately to the studio
Should be Empty: