Chester Valley Dance Academy, LLC Online Registration

Registration

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THE BELOW REGISTRATION FORM IS FOR NEW FAMILIES ONLY!

IF YOU ARE CURRENTLY ENROLLED AT CVDA, PLEASE LOGIN TO THE PARENT PORTAL TO REGISTER!

This form enters you in our online database and enrolls you in all the classes you select below. Tuition fees normally appear in your account in 1-7 days. We accept credit cards, cash, and checks made payable to Chester Valley Dance Academy, LLC.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

Type

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email
( Recommended for Older Dancers )

T-Shirt Size

School

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

To enroll in classes, please click on the Search button below, then choose the class.

Students will be automatically enrolled as long the class capacity has not been reached. If you see you have been put on a wait list this means that you have been put on a waitlist and the class has been closed. Please call call the office at 610-594-2771 for help in enrolling in another class.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email
( Recommended for Older Dancers )

T-Shirt Size

School

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

To enroll in classes, please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email
( Recommended for Older Dancers )

T-Shirt Size

School

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

To enroll in classes, please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email
( Recommended for Older Dancers )

T-Shirt Size

School

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

To enroll in classes, please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email
( Recommended for Older Dancers )

T-Shirt Size

School

Grade Level*

Disabilities*

Special Needs*

Allergies*

Medications*

To enroll in classes, please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

(Show-Hide Details)