Registration
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DANCE TEAM (Company) AUDITIONS
Please sign up and attend your age group time slots.
Call 904-406-4161 or email us at nfdc@comcast.net with any questions.
11:00-11:45am Age 6-9 Jazz and Modern
12:30-1:30pm Age 9-12 Jazz & Modern (Grp A)
1:30-2:15pm Age 8-12 Hip Hop
2:30-3:30pm Age 9-12 Jazz & Modern (Grp B)
3:45-4:45pm Age 13+ Jazz & Modern
4:45-5:30pm Age 13+ Hip Hop
5:30-6:00pm Age 10+ Int/Adv Tap
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Adult Student
Father
Grandparent
Guardian
Mother
Other (Step Parent, Aunt, 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
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Name of academic school (if you attend one):
Allergies or other med/special needs (leave blank if none):
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Name of academic school (if you attend one):
Allergies or other med/special needs (leave blank if none):
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Name of academic school (if you attend one):
Allergies or other med/special needs (leave blank if none):
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Name of academic school (if you attend one):
Allergies or other med/special needs (leave blank if none):
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Name of academic school (if you attend one):
Allergies or other med/special needs (leave blank if none):
Questions/Options:
Please list any dates you are already commited to for summer.
*
Additional Information:
Asbury Art Ctr. Liability Waiver
Parents and/or legal guardians of minor students and adult students assume a certain amount of risk with dance, tumbling, fitness related activities and agree to waive the right to any legal action for any injury sustained on studio property resulting from normal dance activity or any other activity conducted by the students before, during or after class time.
I've read the above and agree.
Payment Policy
I understand that my $15 non-refundable audition fee will be processed upon review of my registration.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Credit Card Verification:
Card Number:
Visa
Mastercard
Amex
Discover
Name as it appears on card:
Nickname:
Card Expiration Month:
01
02
03
04
05
06
07
08
09
10
11
12
Exp Year:
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
2046
2047
2048
2049
2050
Address Line 1:
Address Line 2:
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
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip:
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