THE DANCE COMPANY
You’re just a few steps away from joining the family. Fill out this quick form to register for classes, and get ready to dance, grow, and have fun!
Student Name
First Name
Last Name
Student DOB
Parent/Guardian Name
First Name
Last Name
Relationship to student
Parent/Guardian E-mail
example@example.com
Contact Number
-
Area Code
Phone Number
Secondary Contact Parent/Guardian
First Name
Last Name
Relationship to student
Contact Number
-
Area Code
Phone Number
Students Gender
Male
Female
Prefer not to say
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Where did you hear about us
Facebook
Instagram
Word of mouth/recommendation
Website link
Google search
Poster
Other
What are your dance goals?
Dancing for fun and fitness
Taking part in shows and performances
Competing in competitions
Not sure yet — happy to explore!
Medical Information — Please list any medical conditions, allergies, injuries, or other health concerns we should be aware of:(If none, please write “N/A”)
Signature
Date
-
Month
-
Day
Year
Date
Continue
Continue
Should be Empty: