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 Another 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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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

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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