Lana's Dance Centre,LLC Online Registration

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Welcome to Lana's Dance Centre ,LLC "Where Quality Dancers Turnout Better" and "Dance & Education Connect". We are excited to have you join us! Once you complete the registration form & pay you registration fee we will then add your tuition fees so we can prorate if necessary. You may then pay your tuition. You will be required to have a valid credit card on file at all times. Thank you for choosing Lana's Dance Centre, LLC

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Contact #1

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Contact #2

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Student #1

Student's First Name*

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Additional Info

Student Email

T-Shirt Size*

Grade Level*

Disabilities (If not any write NONE )*

Special Needs (If not any write NONE)*

Allergies ( If not any write NONE)*

Medications (If not any write NONE )*

Primary Doctor*

Dance Exp (Subject: Length ) *

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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Student Email

T-Shirt Size*

Grade Level*

Disabilities (If not any write NONE )*

Special Needs (If not any write NONE)*

Allergies ( If not any write NONE)*

Medications (If not any write NONE )*

Primary Doctor*

Dance Exp (Subject: Length ) *

Dancer Lives with*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

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Student Gender*

Birth Date*

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Additional Info

Student Email

T-Shirt Size*

Grade Level*

Disabilities (If not any write NONE )*

Special Needs (If not any write NONE)*

Allergies ( If not any write NONE)*

Medications (If not any write NONE )*

Primary Doctor*

Dance Exp (Subject: Length ) *

Dancer Lives with*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Grade Level*

Disabilities (If not any write NONE )*

Special Needs (If not any write NONE)*

Allergies ( If not any write NONE)*

Medications (If not any write NONE )*

Primary Doctor*

Dance Exp (Subject: Length ) *

Dancer Lives with*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Grade Level*

Disabilities (If not any write NONE )*

Special Needs (If not any write NONE)*

Allergies ( If not any write NONE)*

Medications (If not any write NONE )*

Primary Doctor*

Dance Exp (Subject: Length ) *

Dancer Lives with*

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class *

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Family Information

Where do you live?

Contact #1

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Contact #2

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Student #1

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