2024 -25 bellAdance Customer Registration Form

2024-25 Dance Registration Form

Please fill in the form below.
Today's Date*

MonthDayYear
Date
New or Returning Student/Family*
Primary E-mail (Note: Email is our PRIMARY form of communication!)*
Email is our #1 form of communication, please let us know if you change yours throughout the year!
Update Contact/billing information (Address/Phone No/Emergency Contacts)?*
Contact and billing information:
Parent #1 Name*

First NameLast Name
Parent #1 Number*
Parent #2 Name

First NameLast Name
Parent #2 Number
Secondary E-mail
Email is our #1 form of communication, please include if you'd like a second email address to receive notices.
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Number of Students Registering*
Students Full Name*

First NameLast Name
Students' Birthday*

MonthDayYear
Date
Age*
Current Academic School (as of fall 2024)*
Allergies or Medical Conditions we should be aware of*
Years of Dance Training*
Where have you trained?
How did you hear about bellA dance?*
Please review the 2024-2025 Class Schedule and indicate below the class(es) you would like to register your student for. bellA dance teachers will review this form and your request and contact you regarding correct class placement prior to verifying your placement.
Student 1 Class Selection (Please select all classes you would like to register this student for. You can select multiple classes by holding down CONTROL while clicking the class. You will specify classes for other student below)*
Additional notes/requests regarding class selection
Total hours of class per week (hours/monthly tuition) Note: This is the price for 1 dancers-there is a discount for multiple family members*

45 minutes $45/mo1 hour $60/mo1 hour 15 minutes $71/mo1 hour 30 minutes $86/mo1 hour 45 minutes $98/mo2 hours $108/mo2 hours 15 minutes $119/mo2 hours 30 minutes $128/mo2 hours 45 minutes $135/mo3 hours $144/mo3 hours 15 minutes $151/mo3 hours 30 minutes $158/mo3 hours 45 minutes $164/mo4 hours $168/mo4 hours 15 minutes $172/mo4 hours 30 minutes $176/mo4 hours 45 minutes $185/mo5 hours $195/mo1 student unlimited $206/moPre Company 1 $164Pre Company 1 + Acro $176Pre Company 2 $168Pre Company 2 + Acro $185
Total hours for student #1*
Additional Students Full Name*

First NameLast Name
Additional Students' Birthday*

MonthDayYear
Date
Age*
Additional Students' Current Academic School*
Allergies or Medical Conditions we should be aware of*
Years of Dance Training*
Where have you trained?
Additional notes regarding class selection
Student 2 Class Selection (Please select all classes you would like to register this student for. You can select multiple classes by holding down CONTROL while clicking the class)*
Total Number of weekly class hours for Additional Student*
Additional Students Full Name*

First NameLast Name
Additional Students' Birthday*

MonthDayYear
Date
Age*
Additional Students' Current Academic School*
Allergies or Medical Conditions we should be aware of*
Years of Dance Training*
Where have you trained?
Student 3 Class Selection (Please select all classes you would like to register for. You can select multiple classes by holding down CONTROL while clicking the class)*
Additional notes regarding class selection
Total Number of weekly class hours for Additional Student*
Total number of combined class hours for all students*
Tuition Information/Policy Acknowledgement*
Withdrawal Policy/Acknowledgement*
Performance Agreement*
Class Etiquette/Dress Code Agreement*
To download a full version of the bellA dance policy agreement, click below.

Registration Fee

Single Student Registration Fee (Required)$30.00

Additional Student$20.00

Family Registration (3 or more)$60.00

Total $0.00

Credit Card

Signature*

Clear
Should be Empty:

3 to 5 year old Ballet & Tap Tuesdays 5:00 pm - 6:00 pm
3 to 5 year old Ballet & Tap Wednesdays 4:00 - 5:00 pm
3 to 5 year old Ballet & Tap Fridays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Saturdays 9:45 am - 10:45 am
4 to 5 year old Ballet & Tap Mondays 4:30 pm -5:30 pm
4 to 5 year old Ballet & Tap Tuesdays 4:00 pm - 5:00 pm
4 to 6 year old Intro to Acro Thursdays 4:00 pm-4:30 pm (30 min)
4 to 5 year old Ballet & Tap Thursdays 4:30 pm - 5:30 pm
4 to 5 year old Ballet & Tap Saturdays 11:00 am- 12:00 pm
6 to 8 year old Acro Monday 4:00 pm - 4:45 pm (45 min)
6 to 8 year old Ballet/Tap/Jazz Mondays 4:45 pm - 6:45 pm (2 hr)
6 to 8 year old Ballet/Tap/Jazz Tuesdays 4:30pm - 6:00 pm (1.5 hr)
6 to 8 year old Hip Hop Wednesdays 4:15 pm - 5:15 pm (1 hr)
6 to 8 year old Ballet/Tap/Jazz Wednesdays 5:00 pm - 6:30 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Thursdays 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Saturdays 10:00 am -12:00 pm (2 hr)
9 to 12 year old Jazz Wednesdays 6:45-`7:30 pm (45 min)
9 to 12 year old Hip Hop Wednesdays 7:30 pm - 8:15pm (45 min)
9 to 12 year old Acro Fridays 4:45 pm - 5:30 pm (45 min)
9 to 12 year old Ballet Fridays 5:30 pm - 6:15 pm (45 min)
9 to 12 year old Tap Fridays 6:15 pm - 7:00 pm (45 min)
Teen Tap Mondays 7:00 pm - 7:45 pm (45 min)
Teen Ballet Mondays 7:45 pm - 8:30 pm (45 min)
Teen Hip Hop Wednesdays 6:45 pm - 7:30 pm (45 min)
Teen Jazz Wednesdays 7:30 pm - 8:15 pm (45 min)
Teen Modern Wednesdays 8:15 pm - 9:00 pm (45 min)
Pre-Company I
Pre- Company I + Acro
Pre-Company II
Pre Company II + Acro
Adult- Saturday class 10 and 11 am
Adult - Tuesday night Tap 6pm

3 to 5 year old Ballet & Tap Tuesdays 5:00 pm - 6:00 pm
3 to 5 year old Ballet & Tap Wednesdays 4:00 - 5:00 pm
3 to 5 year old Ballet & Tap Fridays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Saturdays 9:45 am - 10:45 am
4 to 5 year old Ballet & Tap Mondays 4:30 pm -5:30 pm
4 to 5 year old Ballet & Tap Tuesdays 4:00 pm - 5:00 pm
4 to 6 year old Intro to Acro Thursdays 4:00 pm-4:30 pm (30 min)
4 to 5 year old Ballet & Tap Thursdays 4:30 pm - 5:30 pm
4 to 5 year old Ballet & Tap Saturdays 11:00 am- 12:00 pm
6 to 8 year old Acro Monday 4:00 pm - 4:45 pm (45 min)
6 to 8 year old Ballet/Tap/Jazz Mondays 4:45 pm - 6:45 pm (2 hr)
6 to 8 year old Ballet/Tap/Jazz Tuesdays 4:30pm - 6:00 pm (1.5 hr)
6 to 8 year old Hip Hop Wednesdays 4:15 pm - 5:15 pm (1 hr)
6 to 8 year old Ballet/Tap/Jazz Wednesdays 5:00 pm - 6:30 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Thursdays 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Saturdays 10:00 am -12:00 pm (2 hr)
9 to 12 year old Jazz Wednesdays 6:45-`7:30 pm (45 min)
9 to 12 year old Hip Hop Wednesdays 7:30 pm - 8:15pm (45 min)
9 to 12 year old Acro Fridays 4:45 pm - 5:30 pm (45 min)
9 to 12 year old Ballet Fridays 5:30 pm - 6:15 pm (45 min)
9 to 12 year old Tap Fridays 6:15 pm - 7:00 pm (45 min)
Teen Tap Mondays 7:00 pm - 7:45 pm (45 min)
Teen Ballet Mondays 7:45 pm - 8:30 pm (45 min)
Teen Hip Hop Wednesdays 6:45 pm - 7:30 pm (45 min)
Teen Jazz Wednesdays 7:30 pm - 8:15 pm (45 min)
Teen Modern Wednesdays 8:15 pm - 9:00 pm (45 min)
Pre-Company I
Pre- Company I + Acro
Pre-Company II
Pre Company II + Acro
Adult- Saturday class 10 and 11 am
Adult - Tuesday night Tap 6pm

3 to 5 year old Ballet & Tap Tuesdays 5:00 pm - 6:00 pm
3 to 5 year old Ballet & Tap Wednesdays 4:00 - 5:00 pm
3 to 5 year old Ballet & Tap Fridays 4:30 pm - 5:30 pm
3 to 5 year old Ballet & Tap Saturdays 9:45 am - 10:45 am
4 to 5 year old Ballet & Tap Mondays 4:30 pm -5:30 pm
4 to 5 year old Ballet & Tap Tuesdays 4:00 pm - 5:00 pm
4 to 6 year old Intro to Acro Thursdays 4:00 pm-4:30 pm (30 min)
4 to 5 year old Ballet & Tap Thursdays 4:30 pm - 5:30 pm
4 to 5 year old Ballet & Tap Saturdays 11:00 am- 12:00 pm
6 to 8 year old Acro Monday 4:00 pm - 4:45 pm (45 min)
6 to 8 year old Ballet/Tap/Jazz Mondays 4:45 pm - 6:45 pm (2 hr)
6 to 8 year old Ballet/Tap/Jazz Tuesdays 4:30pm - 6:00 pm (1.5 hr)
6 to 8 year old Hip Hop Wednesdays 4:15 pm - 5:15 pm (1 hr)
6 to 8 year old Ballet/Tap/Jazz Wednesdays 5:00 pm - 6:30 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Thursdays 4:30 pm - 6:00 pm (1.5 hr)
6 to 8 year old Ballet/Tap/Jazz Saturdays 10:00 am -12:00 pm (2 hr)
9 to 12 year old Jazz Wednesdays 6:45-`7:30 pm (45 min)
9 to 12 year old Hip Hop Wednesdays 7:30 pm - 8:15pm (45 min)
9 to 12 year old Acro Fridays 4:45 pm - 5:30 pm (45 min)
9 to 12 year old Ballet Fridays 5:30 pm - 6:15 pm (45 min)
9 to 12 year old Tap Fridays 6:15 pm - 7:00 pm (45 min)
Teen Tap Mondays 7:00 pm - 7:45 pm (45 min)
Teen Ballet Mondays 7:45 pm - 8:30 pm (45 min)
Teen Hip Hop Wednesdays 6:45 pm - 7:30 pm (45 min)
Teen Jazz Wednesdays 7:30 pm - 8:15 pm (45 min)
Teen Modern Wednesdays 8:15 pm - 9:00 pm (45 min)
Pre-Company I
Pre- Company I + Acro
Pre-Company II
Pre Company II + Acro
Adult- Saturday class 10 and 11 am
Adult - Tuesday night Tap 6pm

2024-25 Dance Registration Form

Contact and billing information:

Credit Card