Registration
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Come and kickoff the new dance season with at our ETD Day of Dance on August 10, 2019. Take all the dance classes you want for FREE, meet the studio Director, get all your questions answered about our classes and complete registration.
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Aunt
Caregiver
Father
Grandparent
Guardian
Mother
Parent
Self
Step Father
Step Mother
Uncle
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Emergency Contact Info (Not Contact #1 or #2)
*
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Birth Date:
*
(format=mm/dd/yyyy)
Student Email (enter if student has an email address)):
School Name:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Birth Date:
*
(format=mm/dd/yyyy)
Student Email (enter if student has an email address)):
School Name:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Birth Date:
*
(format=mm/dd/yyyy)
Student Email (enter if student has an email address)):
School Name:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Birth Date:
*
(format=mm/dd/yyyy)
Student Email (enter if student has an email address)):
School Name:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Birth Date:
*
(format=mm/dd/yyyy)
Student Email (enter if student has an email address)):
School Name:
*
Grade Level:
*
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilities (Leave blank if NONE):
Allergies:
*
Medications:
*
Primary Doctor:
Questions/Options:
What classes are you interested in?
*
What is the age of your dancer(s)?
*
Additional Information:
Other Questions/Comments:
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