Registration Form

Adult responsible for student:

* Indicates required field

Name *

First

Last

Relationship *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

What other adults can be contacted if the student needs to be picked up from the studio?

Name *

First

Last

Phone Number *

Name *

First

Last

Phone Number *

Student Information:

Please enter registration information for ALL students enrolling. Class times and dates will be determined after form is received.

Dancer One *

First

Last

Allergies or Concerns *

Birthdate (mm/dd/yr) *

Current Grade Level *

Gender: *

Dancer Two *

First

Last

Allergies or Concerns *

Birthdate (mm/dd/yr) *

Current Grade Level *

Gender: *

Dancer Three *

First

Last

Allergies or Concerns *

Birthdate (mm/dd/yr) *

Current Grade Level *

Gender: *

Dancer Four *

First

Last

Allergies or Concerns *

Birthdate (mm/dd/yr) *

Current Grade Level *

Gender : *

Studio Policies:

We frequently take photographs and videos during class. Do we have permission to use your child's photo in our advertising or class emails?

Please Respond: *

Sure! No Thanks.

Please type your name below to serve as your signature.

Signature *

Submit

​​Try a Class for Free!

Adult responsible for student:

Student Information:

Studio Policies:

Try a Class for Free!