Registration

Style: Junior Jazz (7-11) Junior Tap (7-11) Junior Acro (7-11) Junior Hip Hop (7-11) Senior Jazz (12+) Senior Tap (12+) Senior Hip Hop (12+) Senior Contemporary (12+) Senior Ballet (12+) Senior Acro (12+)
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/Prov: * Postal Code: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Student Name#1: Student Name#2: Student Name#3:*
Date of Birth and Age: Student#1: Student#2: Student#3:*
School Grade in September: Student#1: Student#2: Student#3:*
E-mail Address: *
New Student with Great Lakes Dance Academy. Please list your Dance Experience (style and years studied): Student#1: Student#2: Student#3:*
I am auditioning for: (see description for Style)(indicate if Intensive Study or Intensive Study and Company) Student#1: Student#2: Student#3:*
Would you be willing to do a solo routine if selected, if yes what style would you prefer: Student#1: Student#2: Student#3:*
 
Additional Information:
 
Intensive Study and Company Audition Agreement Form
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I've read the above and agree.
 
Enter your Full Name: *   
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
Country: *
City: State/Prov: * Postal Code:*