Dance Arts Academy Online Registration

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1015 S. Garfield Avenue Traverse City, MI 49686 Phone 231.941.4244 Email info@danceartstraverse.com Website www.danceartstraverse.com

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Referral Information

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Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

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*

Additional Info

If any Special Needs/Disabilities, please list (LEAVE BLANK if NONE)

If any Allergies, please list (LEAVE BLANK if NONE)

Medications (LEAVE BLANK if NONE)

Please contact the studio with any questions regarding class placement. Choose any filter (Preschool, Pre-K, Beg, Cont, Int, Adv) to narrow your search.

Summer Semester Ages are as of June 1.

Fall/Winter/Spring Semester Ages are as of September 1.

Some classes require prerequisites or Director permission.

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

If any Special Needs/Disabilities, please list (LEAVE BLANK if NONE)

If any Allergies, please list (LEAVE BLANK if NONE)

Medications (LEAVE BLANK if NONE)

Please contact the studio with any questions regarding class placement. Choose any filter (Preschool, Pre-K, Beg, Cont, Int, Adv) to narrow your search.

Summer Semester Ages are as of June 1.

Fall/Winter/Spring Semester Ages are as of September 1.

Some classes require prerequisites or Director permission.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

If any Special Needs/Disabilities, please list (LEAVE BLANK if NONE)

If any Allergies, please list (LEAVE BLANK if NONE)

Medications (LEAVE BLANK if NONE)

Please contact the studio with any questions regarding class placement. Choose any filter (Preschool, Pre-K, Beg, Cont, Int, Adv) to narrow your search.

Summer Semester Ages are as of June 1.

Fall/Winter/Spring Semester Ages are as of September 1.

Some classes require prerequisites or Director permission.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

If any Special Needs/Disabilities, please list (LEAVE BLANK if NONE)

If any Allergies, please list (LEAVE BLANK if NONE)

Medications (LEAVE BLANK if NONE)

Please contact the studio with any questions regarding class placement. Choose any filter (Preschool, Pre-K, Beg, Cont, Int, Adv) to narrow your search.

Summer Semester Ages are as of June 1.

Fall/Winter/Spring Semester Ages are as of September 1.

Some classes require prerequisites or Director permission.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

If any Special Needs/Disabilities, please list (LEAVE BLANK if NONE)

If any Allergies, please list (LEAVE BLANK if NONE)

Medications (LEAVE BLANK if NONE)

Please contact the studio with any questions regarding class placement. Choose any filter (Preschool, Pre-K, Beg, Cont, Int, Adv) to narrow your search.

Summer Semester Ages are as of June 1.

Fall/Winter/Spring Semester Ages are as of September 1.

Some classes require prerequisites or Director permission.

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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Referral Information

Family Information

Where do you live?

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

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Student #2 (Show-Hide Details)

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Student #3 (Show-Hide Details)

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