KEDA CO Performing Arts
2026/2027 Company Member Registration Form
Student Information
Student Full Name:
Date of Birth:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age:
Parent/Guardian Name (if under 18):
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Home Address:
Emergency Contact
Name:
Relationship:
Phone Number:
Format: (000) 000-0000.
Membership Information
Company Division
Tiny Team (ages 2-4)
Mini Company (ages 4-7)
Junior Company (ages 8-12)
Senior Company (ages 13-17)
Adult Company (ages 18+)
Membership Type
Please select one:
Membership Type
Mini Trainee/ Tiny Team (2 hours or less)
Mini Apprentice (4+ Hours)
Mini Corps (6+ hours)
Jr/Sr Trainee (2 hours or less)
Jr/ Sr Apprentice (4+ hours)
Jr/ Sr Corps (6+ Hours)
Jr/Sr Principle (unlimited)
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Dance & Performance Experience
Previous Dance Training
Please list all styles studied and years of experience:
Please list all styles studied and years of experience:
Rows
Years of Experience
Current/Previous Studio
Ballet
Jazz
Tap
Contemporary
Modern
Acro
Musical Theatre
Other:
Performance & Competition Experience
Please describe any performances, competitions, conventions, or special training attended:
Special Skills or Certifications
(acro skills, tumbling, vocal training, choreography, etc.)
Scholarship & Tuition Information
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Tuition Payment Method
Self-Pay
Applying for Scholarship Assistance
Scholarship Information
If using scholarship funding, please provide scholarship name/provider:
Scholarship Application Request
I would like to apply for a scholarship through KEDA CO Performing Arts.
Medical Information
Allergies / Medical Conditions
Medications or Important Health Information
Photo & Media Release
I give permission for KEDA CO Performing Arts to use photos/videos of the student for promotional, educational, and social media purposes.
I do NOT give permission for photos/videos to be used.
Agreement to Company Policies & Procedures
By signing below, I acknowledge that I have read and agree to follow all KEDA CO Performing Arts policies, procedures, rehearsal expectations, attendance requirements, costume guidelines, performance commitments, and code of conduct.
I understand that failure to follow company policies may affect participation status.
I also understand that tuition, fees, and scholarship approvals are subject to company guidelines and deadlines.
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Signature Section
Student Signature:
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Parent/Guardian Signature (if under 18):
Date:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Office Use Only
Date Received:
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Audition/Placement Level:
Scholarship Approved:
Yes
No
Staff Notes:
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