Registration

What to Wear: We want all guests to feel comfortable and ready to move, so athletic attire that allows freedom of movement is the way to go.

Event:

Start Date/Time:

End Date/Time:

Fee per Family:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email ( Recommended for Older Dancers ):
	School:	Grade Level:*
	Disabilities:*
	Allergies:*
	Medications:*

Questions/Options:


What Class(es) would you like to dance with your friend in? Please list the class name, day of the week, and time.*

Additional Information:

Policy Agreement

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