Dance Registration Form 2025-2026

Student Registration Form

2025-2026
Dancer's Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Dancer's Age
School Attending*
Type None if not in school.
Grade in school this year*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent's Name or Guardian's Name*

First NameLast Name
Parent E-mail*
Parent Cell Number*

Area CodePhone Number
Parent Work Number*

Area CodePhone Number
Name of Emergency Contact*

First NameLast Name
Emergency Contact Number*

Area CodePhone Number
How many years of dance experience do you have?*
Type a number for past experience, not counting this year.
The name of the last studio in which you studied*
Type None if this is your first year.
Check additional classes you are interested in.

Ballet Technique ( minimum 3rd grade)Hip Hop ( 5 years of age and up)Turns, Leaps, Flexibility ( miniumum 5th grade)
Additional Comments
Any request for class scheduling
Should be Empty:

Student Registration Form