New Customer Registration Form

Empire Dance Company 2026 Registration Form

This registration form is intended for ONE dancer at a time. For families enrolling multiple students, please complete a new form for each dancer.
Customer Details:
Parent Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Student Information
Student Name
Birth Date

MonthDayYear
Date
Class Selection*

Mini Ballerinas Wed 3:45pmReady Set Dance Tuesday 10:30amReady Set Dance Tues 3:30pmReady Set Dance Friday 9:00amLittle Acro Thurs 3:30pmAcrobatics (7-12yrs)Junior Circus ClassPrimary CircusMini Combo (5-7years)Junior Combo (7-9yrs)Primary Combo (9-12yrs)Teen Combo (12 +)BboysPrivateMini SilksAerial Silks5/u Troupe8/u Troupe10/u Troupe12/u TroupeSenior Troupe8/u Balletics10/u Balletics12/u BalleticsSenior BalleticsOpens ClassJunior SkillsSenior SkillsLadies ClassEx-Dancers ClassMini CheerCheer Leading

My Products*

Registration Fee

This registration fee covers ONE student for registration to Empire Dance Company which covers their insurance for Dance, Acrobatics and Aerial Silks. For other children please fill out another form.

$40.00AUD

Total

$0.00AUD

Payment Methods

Credit Card

Apple Pay

Should be Empty:

Empire Dance Company 2026 Registration Form

Student Information

Payment Methods