WEBBY Dance Company - Tampa Online Registration

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We are now offering fun and exciting weekly WEBBY classes at your child's school! Children will benefit by building their memory, concentration, coordination, creativity and self-confidence, all in a positive atmosphere. Sign up to reserve your spot!! Registration for the 2024-2025 School Year NOW OPEN!

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Referral Information

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Referral Name

Family Information

Student Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

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Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

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Portal Access (your email is your login)

Email* (Emails are kept confidential)

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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 WEBBY Dance Company - Tampa. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

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Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs/ Info for Teacher

Food Allergies

Classroom Teacher’s Name?

Please select the class in which you would like to enroll your child.

ALL STUDENTS WILL BE ENROLLED IN AUTO-PAYMENT

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs/ Info for Teacher

Food Allergies

Classroom Teacher’s Name?

Please select the class in which you would like to enroll your child.

ALL STUDENTS WILL BE ENROLLED IN AUTO-PAYMENT

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs/ Info for Teacher

Food Allergies

Classroom Teacher’s Name?

Please select the class in which you would like to enroll your child.

ALL STUDENTS WILL BE ENROLLED IN AUTO-PAYMENT

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs/ Info for Teacher

Food Allergies

Classroom Teacher’s Name?

Please select the class in which you would like to enroll your child.

ALL STUDENTS WILL BE ENROLLED IN AUTO-PAYMENT

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs/ Info for Teacher

Food Allergies

Classroom Teacher’s Name?

Please select the class in which you would like to enroll your child.

ALL STUDENTS WILL BE ENROLLED IN AUTO-PAYMENT

Enroll in Classes

Select Class

Add Another Student

Required Policies

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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

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I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

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