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ESOTA 2025-2026 Registration Form
Student Name
*
First Name
Last Name
Parent/Guardian #1
*
First Name
Last Name
Parent/Guardian #2
First Name
Last Name
Mailing Address
*
Street Address
Apartment Number if applicable
City
State / Province
Postal / Zip Code
Student's Cell Phone Number
Please enter a valid phone number.
Parent #1's Home Phone
Please enter a valid phone number.
Parent #1's Cell Phone Number
*
Please enter a valid phone number.
Parent #2's Home Phone
Please enter a valid phone number.
Parent #2's Cell Phone Number
Please enter a valid phone number.
Student's Email
example@example.com
Parent's Email #1 (for class distribution lists)
*
example@example.com
Parent's Email #2 (for class distribution lists)
If none, write n/a.
Emergency Contact #1 Name
*
Contact Name (other than parent listed)
Emergency Contact #1 Phone
*
Please enter a valid phone number.
Emergency Contact #1 Relationship
*
Relationship to student
Emergency Contact #2 Name
*
Contact Name, other than parent listed. If a second contact not available, please write n/a
Emergency Contact #2 Phone
*
Please enter a valid phone number. If none, write n/a.
Emergency Contact #2 Relationship
*
Relationship to student. If none, write n/a.
Student's Age
*
Date of Birth
*
-
Month
-
Day
Year
Student's Academic School
*
Student's Grade
*
How did you hear about ESOTA?
*
Student Enrollment - Select One
*
Please Select
New Student
Returning Student
Alumnus
Please indicate your child's enrollment status
Pick Up Restrictions/Court Orders
*
Please list any details. If none, write n/a.
Is there a court order in effect? If so, please upload a copy.
*
Yes
No
Court Order File Upload
Browse Files
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Choose a file
Please upload any court order in effect if applicable
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Previous Dance Experience - schools attended and number of years at each
*
Please list any previous dance experience. If none, write n/a.
Other Relatives Enrolled in ESOTA
*
Please list the name(s) and relationship to any current or former ESOTA students. If none, write n/a.
Does the Student have Consent to Walk Home Alone?
*
Yes
No
Does the Student have Consent to Leave the Building for Lunch?
*
Yes
No
Medical Conditions
*
Please list any medical conditions, including allergies and medications taken. If none, write n/a.
Parent's Occupation
*
Please list the occupation of parent(s)/guardian(s). If none, write n/a.
Classes - please select all classes your child will take (please review schedule) Consecutive classes required of Babies and Children's class students
*
Ballet
Tap
African
Hip Hop/Majorette (ages 5 and up)
Jazz (not offered to Babies Class)
Modern (not offered to Babies)
Pointe {Lil Pro (invitation only), Junior Pro, Junior Senior Pro, Aspiring Dancers classes only}
African Drum
Turns/Leaps/Workshop (Junior Pro, Junior Senior Pro and Aspiring Dancers classes only)
Please check your child's class name. Classes are based on the child's age. PEP classes should only be selected by those who were enrolled in one of these classes during the 2024-2025 Season.
*
Babies (ages 3-6)
Children (ages 7-11)
Teens (ages 12-17)
Tiny Tot - PEP Class
Super Tots - PEP Class
Lil Pro - PEP Class
Junior Pro - PEP Class
Junior Senior Pro - PEP Class
Aspiring Dancers - PEP Class
Is your child vaccinated?
*
Yes
No
If so, please upload a copy of the most recent vaccination record. It is not required for registration at this time.
Browse Files
Drag and drop files here
Choose a file
Please upload copy.
Cancel
of
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
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