Rockin' Horse Dance Barn Online Registration

Registration

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Welcome. If you have ANY questions call 425-255-9211.

Each registration is meant for just you & your significant other and/or dependents
If you are setting up a group of people you should setup a different Account for each couple/family in your group. (This allows them to Enroll on their own in the future)
If you want to pay for a group with one Payment please call

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Referral Information

How did you hear about us?*

Referral Name

Information

Where do you live?

Home Address*

City*

State*

Zip*

Contact #1

Contact Person First Name*

Last Name *

How Can We Contact You?

Home Phone *

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email*

If you are registering more than one person be sure to ADD ANOTHER STUDENT down below after you SELECT CLASS. Don't forget to SELECT CLASS for them too. After finishing all the student info scroll down to enter your PAYMENT INFO and hit SUBMIT REGISTRATION.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email*

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 #*

Additional Info

Student Email*

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 #*

Additional Info

Student Email*

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 #*

Additional Info

Student Email*

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

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

Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

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