B-Town Twirlers Fall Registration

B-Town Twirlers

Fall Registration 2026
Name

First NameLast Name
Date of birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact Name

First NameLast Name
Relationship to Student
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Level of Experience
Registration Info
Student Shirt Size (Comfort Color Brand)
Additional Shirts are available to order for $20 each! We will be sending home information for this at our first class!
Sibling Discount
Sibling Information (if applicable)
Preferred Class Day
Medical Conditions or Allergies
Terms and Conditions:

By submitting this form, I acknowledge that participation in dance classes involves physical activity and I hereby release the dance studio and its instructors from any liability for injuries or accidents that may occur during classes or events. You are also acknowledging that you will be receiving emails and texts concerning important information. All information is also available on our Private Facebook Group.
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Adult Registration

$25.00 Quantity



Adult Registration
Registration is FREE if you have a child signed up for classes!

Free Quantity



New Student Fall Registration (Youth)
Includes Your Child's Company Shirt

$45.00 Quantity



Returning Student Fall Registration (Youth)
Does NOT include a shirt

$25.00 Quantity



Sibling Discount
Please text us for your total!

Free Quantity



Total

$0.00
Registration Payment Method
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

B-Town Twirlers

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Additional Information

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