Registration

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Keep exercising from home with our virtual adult dance classes! Please fill out the form below. EACH CLASS PARTICIPANT SHOULD BE LISTED AS A STUDENT BELOW. Once you register, the zoom link and password will be sent to you via email. You should only dance in your tap shoes at home if you have a tap board, Marley/vinyl dance floor, or disposable wood to dance on. Tap shoes can be damaging to wood floors and become slippery on tile or laminate flooring. If necessary, please tap in bare feet, jazz shoes, or sneakers.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

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*

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: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Primary Doctor:

Questions/Options:


Will any children be attending?*
If YES, how many? (Enter N/A if no children are attending)*

Additional Information:

Disclaimer

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