Panorama School of Dance Online Registration

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Referral Information

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Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State/Prov*

Postal Code*

Home or Primary Phone*

Additional Info

Emergency Contact Info*

Contact #1

Contact #1 First Name*

Last Name *

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Home Phone *

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Contact #2

Contact #2 First Name

Last Name

Type

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Work #

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Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Year started at PSOD?*

All enrollments will be reviewed before considered final. Please note that if you are registering in a ballet class Primary level or higher, your child must register in two of the same level.

Enroll in Classes

Select Another Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Year started at PSOD?*

All enrollments will be reviewed before considered final. Please note that if you are registering in a ballet class Primary level or higher, your child must register in two of the same level.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Year started at PSOD?*

All enrollments will be reviewed before considered final. Please note that if you are registering in a ballet class Primary level or higher, your child must register in two of the same level.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Year started at PSOD?*

All enrollments will be reviewed before considered final. Please note that if you are registering in a ballet class Primary level or higher, your child must register in two of the same level.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Year started at PSOD?*

All enrollments will be reviewed before considered final. Please note that if you are registering in a ballet class Primary level or higher, your child must register in two of the same level.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

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Covid Policy

I've read the above and agree.

Closing Policies

I've read the above and agree.

Release of Liability

I've read the above and agree.

Parent Responsibility

I've read the above and agree.

Dress Code

I've read the above and agree.

Media Release

I've read the above and agree.

Payment Policies

I've read the above and agree.

I Agree to All of the Above

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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

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Student #2 (Show-Hide Details)

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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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Enroll in Classes

Required Policies and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

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Credit Card

eCheck/Bank Draft

Required Policies and Agreements

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