Dance For His Glory Online Registration

Registration

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D4HG 2025-26 Dance Registration Complete below registration form. When choosing a Payment Option refer to this information. Option #1 - pay on 1st of the month with Credit Card that D4HG runs, #2-pay before the 10th of the month with a Credit Card that I run through Family Portal, #3-pay with cash or check by the 10th of the month to receive a $2 discount per class per month (August-April). After check out and Registration fee and May 2026 have been paid your student is registered

* 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*

Are you a member of FBCW?*

If no, where*

Payment option #1 (Y/N)*

Payment option #2 (Y/N)*

Payment option #3 (Y/N)*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

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 # * Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Photo Release? (Y/N)*

Video Release? (Y/N)*

Have you had lessons before?*

If yes, where? If no, N/A*

If yes, how long? If no, N/A*

Choose any filter to narrow your search.

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Photo Release? (Y/N)*

Video Release? (Y/N)*

Have you had lessons before?*

If yes, where? If no, N/A*

If yes, how long? If no, N/A*

Choose any filter to narrow your search.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Photo Release? (Y/N)*

Video Release? (Y/N)*

Have you had lessons before?*

If yes, where? If no, N/A*

If yes, how long? If no, N/A*

Choose any filter to narrow your search.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Photo Release? (Y/N)*

Video Release? (Y/N)*

Have you had lessons before?*

If yes, where? If no, N/A*

If yes, how long? If no, N/A*

Choose any filter to narrow your search.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance For His Glory. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Photo Release? (Y/N)*

Video Release? (Y/N)*

Have you had lessons before?*

If yes, where? If no, N/A*

If yes, how long? If no, N/A*

Choose any filter to narrow your search.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

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

Account Information

Credit Card

Required Policies

(Show-Hide Details)