Registration
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Our New York City trip includes airfare, hotel accommodations, a Broadway show, Radio City Music Hall Backstage Tour, 1 Open Class at Broadway Dance Center, NYC Ballet show and MUCH MORE! You must attend our October 12th Interest Meeting via Google Meet before receiving the New York City Trip packet.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Aunt
Caregiver
Father
Grandparent
Guardian
Mother
Parent
Self
Step-Parent
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)
*
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
Non-Binary
Transgender
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
*
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
Kindergarten
Pre-K
Preschool
Allergies:
*
Dance and/or music experience:
*
If yes, where?:
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Transgender
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
*
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
Kindergarten
Pre-K
Preschool
Allergies:
*
Dance and/or music experience:
*
If yes, where?:
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Transgender
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
*
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
Kindergarten
Pre-K
Preschool
Allergies:
*
Dance and/or music experience:
*
If yes, where?:
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Transgender
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
*
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
Kindergarten
Pre-K
Preschool
Allergies:
*
Dance and/or music experience:
*
If yes, where?:
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Non-Binary
Transgender
Birth Date:
*
(format=mm/dd/yyyy)
Grade Level:
*
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
Kindergarten
Pre-K
Preschool
Allergies:
*
Dance and/or music experience:
*
If yes, where?:
Additional Information:
Interest Meeting Agreement
(Show-Hide Details)
I agree to attend the October 12th Interest Meeting via Google Meet before receiving the New York City Trip packet.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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