Summer 2026 Registration

Summer 2026

Registration
Student Name*

First NameLast Name
Age at time of registration*
Date of Birth*

MonthDayYear
Date
Parent Name (if under 18)

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Which Session or Intensive would you like to register for?*
If more than one please select all that apply.
4 Week June 1-27 Session Options*
If more than one please select all that apply. June 1st-27th
6 Week July 5-August 15 Session Options*
If more than one please select all that apply. July 5th - August 15th
Please tell us about any allergies, medical, or special circumstances we may need to know about.
Waiver of Liability: By submitting this form I agree to the following waiver of liability.

I acknowledge the risk in physical activity during dance, fitness, and movement classes and release Dirigo Conservatory of Movement from all liability of injury that may occur while participating in said risk.
Payment is due prior to the first class and can be made in the form of cash, check to Dirigo Consveratory of Movement, or Venmo @Morgan-Sanborn.
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