Joy in Motion Online Registration

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Summer Registration is OPEN! Fall '25 Schedule and Dates for Priority and Open Registration will be posted to our site in late June.

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Referral Information

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Referral Name

Family Information

Account Last Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info<br/>Who should we call 1st? You may also add more Emergency contacts here*

Health Insurance/Hospital

Vet/Enlisted/1st Responder?

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Contact #1

Adult Contact #1 First Name*

Last Name *

Relation to Student(s)*

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Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

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Contact #2

Adult Contact #2 First Name

Last Name

Relation to Student(s)

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School

Grade Level - '25-'26 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Does dancer go by a nickname?

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School

Grade Level - '25-'26 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Does dancer go by a nickname?

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School

Grade Level - '25-'26 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Does dancer go by a nickname?

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School

Grade Level - '25-'26 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Does dancer go by a nickname?

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School

Grade Level - '25-'26 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Does dancer go by a nickname?

Enroll in Classes

Select Class

Add Another Student

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Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

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Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

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