Registration
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Join us for a day in the life as a KP Dance Company Member. We will be offering a variety of different styled classes for all ages. Whether you're a beginner or advanced we are open to welcoming ALL starting as young as just 4 yrs old! Get a sneak peek into the dynamic world of competitive dance . While Alumni, Company Directors, Members and experienced Dance Moms are present to help discuss any questions that you may have! Meet the teachers and your possible future team!
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
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- denotes required fields
Family Information
First Name:
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Last Name:
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Home Phone:
Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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AK
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DE
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GA
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ID
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ME
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OR
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TN
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VA
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WA
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Zip:
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies:
Add New Student #2:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies:
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies:
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies:
Add New Student #5:
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Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Disabilities (Leave blank if NONE):
Allergies:
Additional Information:
Waiver
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I understand & agree participating in any dance class is a possibility of physical injury. I voluntarily agree, therefore to assume all risks & responsibility for any such injury/accident. I also understand that KP Dance Center is not responsible for lost/stolen property inside/outside the building/parking lot. Permission is granted to KP Dance Center to use photographs for publicity purposes. I have read, understood and agree. This applies to myself, my dancer(s) and any person(s) I bring to KP Dance Center at any of their locations. I also understand and agree ALL payments are non-refundable.
I've read the above and agree.
Enter your Full Name:
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