Bloom Dance Class Registration
Monday & Fridays Dance and Gymnastics classes at Bloom. Your child will learn both Ballet and Tap On Mondays and Gymnastics on Fridays. Parent pick up instructions will be sent via email prior to the first week of dance. PLEASE Fill out the form carefully for registration. We will contact you with whatever Email address is filled out. We give you a discounted rate if your child is in Both Monday and Wednesday classes. For any Additional Information, Please check out our website and Follow us on Facebook to stay up to date on important news!
Dancers Name
*
First Name
Middle Name
Last Name
Birth Date
*
Please select a month
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Day
Please select a year
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Year
Gender
Please Select
Male
Female
N/A
What Day Will your child be attending class.
*
Please Select
Mondays 1:30-2:30(open to the public)
Mondays 2:00-3:00 3-5s(open to the public)
Mondays 3:15-4 3-5s
Mondays 4:10-5:10 6-9s
Fridays Gymnastics 1:30-2:30(open to the public)
Fridays Gymnastics 2:00-3:00 3-5s(open to the public)
Fridays Gymnastics 3:15-4 3-5s
Fridays Gymnastics 4:10-5:10 6-9s
Both Days Mon & Fri
Does your child attend Bloom or will they be coming from outside of the facility?
*
Does your child have allergies?
Mothers Name
*
First Name
Last Name
Fathers Name
First Name
Last Name
Mothers E-mail
*
Please be sure this is a Primary Email you check
Fathers E-mail
Primary Email
Mothers Number
*
Format: (000) 000-0000.
Fathers Number
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Number
*
Format: (000) 000-0000.
Relation to Dancer
I understand that Dance and Gymnastics are both a physical activity and I cannot hold any Super Stars Dancers employees accountable, Nor the facility staff Accountable if anything Happens during class time.
*
Names of people with permission to pick up your child from Dance class.
*
Payment Information: $300 per class per semester
Processing fee is added. if not paying by a card below you can pay via Venmo or zelle. PLEASE ADD your child's Name, School and Days attending when you make your payment Venmo: Catherine-Wood-7 | Zelle: 832-545-0463
Card Payments: These include a processing fee.
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One Day a Week
$310.00
$
310.00
Quantity
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10
Two Days a Week
$620.00
$
620.00
Quantity
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9
10
Dance Attire Starter pack
Leotard, Tights and a skirt.
$40.00
$
40.00
Quantity
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Ballet Shoes
$25.00
$
25.00
Quantity
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10
Tap Shoes
$35.00
$
35.00
Quantity
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9
10
Super Stars Dance Tote bag with logo and childs name
$45.00
$
45.00
Quantity
1
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9
10
Credit Card
If you will not be paying with CC you must send the payment Today unless Discussed with Miss Cat. Payments that are not sent the day or Registration are subject to a fee of $25. If you will be paying another way please choose which Payment form below,
Please Select
Venmo
Zelle
If you picked Zelle or Venmo you are agreeing to sending the payment within the same Day unless you need to make arrangements then you will send Miss Cat an Email the same day requesting arrangements to be made. You agree to the fee stated above if the payment is not sent within the same day of registering your child
*
Yes
I paid by Card
Dance class attire:
Black Leotard, Pink tights, Pink Ballet shoes, Black tap shoes (if applicable), Skirt of any color if desired. Jazz & Hip Hop will need Black Jazz shoes, Jazz pants and a Black T-Shirt. Super Stars Dancers T-Shirts are for sale for anyone who is interested, Please send an email inquiring if so!
Can we use your child's photos from class/camps/shows on our website and social media's? We will never add their name or personal information.
*
Yes
No
Follow us on Facebook and Instagram, we post news and updates plus add photos and snippets of classes and camps!
https://www.instagram.com/superstarsdancers/
Any additional Notes to the SSD Team can be added below
Submit
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