Dance City Online Registration

Registration

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We are so excited to have you join us for the 2023-2024 dance season!

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State/Prov*

Postal Code*

Primary Phone*

Additional Info

Emergency Contact Info

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

Who is your employer?

Employer

Employer Phone

Employer Notes

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Thank you for registering with Dance City. If you are in a Foundation, Progression and Competitive full season classes please note that your bodysuit, tights will be available for purchase though Dance City. You are welcome to get sized and pick up your items during our office hours:

Monday 1:00 p.m. - 7:30 p.m.
Tuesday 2:00 p.m. - 7:30 p.m.
Wednesday 1:00 p.m. - 7:30 p.m.
Thursday 1:00 p.m. - 7:30 p.m.
Friday CLOSED
Saturday 9:00 a.m. - 1:00 p.m.
Sunday CLOSED

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Monday 1:00 p.m. - 7:30 p.m.
Tuesday 2:00 p.m. - 7:30 p.m.
Wednesday 1:00 p.m. - 7:30 p.m.
Thursday 1:00 p.m. - 7:30 p.m.
Friday CLOSED
Saturday 9:00 a.m. - 1:00 p.m.
Sunday CLOSED

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Monday 1:00 p.m. - 7:30 p.m.
Tuesday 2:00 p.m. - 7:30 p.m.
Wednesday 1:00 p.m. - 7:30 p.m.
Thursday 1:00 p.m. - 7:30 p.m.
Friday CLOSED
Saturday 9:00 a.m. - 1:00 p.m.
Sunday CLOSED

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Monday 1:00 p.m. - 7:30 p.m.
Tuesday 2:00 p.m. - 7:30 p.m.
Wednesday 1:00 p.m. - 7:30 p.m.
Thursday 1:00 p.m. - 7:30 p.m.
Friday CLOSED
Saturday 9:00 a.m. - 1:00 p.m.
Sunday CLOSED

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Monday 1:00 p.m. - 7:30 p.m.
Tuesday 2:00 p.m. - 7:30 p.m.
Wednesday 1:00 p.m. - 7:30 p.m.
Thursday 1:00 p.m. - 7:30 p.m.
Friday CLOSED
Saturday 9:00 a.m. - 1:00 p.m.
Sunday CLOSED

Enroll in Classes

Select Class

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Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

Country *

City

State/Prov*

Postal Code*

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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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

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Student #3 (Show-Hide Details)

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