The Dance Co. Online Registration

Registration

Thank you for choosing The Dance Co.! As we enter our 32nd year, we are excited that you have chosen to allow your child to be a part of our dance family! Once you have filled out the registration form, there will be a $25 registration fee charged to your account. Please contact us at (985) 532-0110 if you have any questions or if we can help you in any way!

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info Other Than Parent (Name & Phone Number and relationship to the student)*

Contact #1

First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Contact #2

First Name*

Last Name*

Type*

How can we contact you?

Home Phone *

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

School*

Grade Level (entering in August 2024)*

Medical History/Disabilities/Illnesses (Including ADD/ADHD, Dyslexia, Behavioral Disorders)*

Special Needs*

Allergies*

Medications *

Religion Class Day & Time:*

Weekly Activities Day & Time:*

Pre-Pointe (Y/N) 9 yo. & up:*

Hip Hop (Y/N) 1st grade & up:*

Previous years of dance:*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

School*

Grade Level (entering in August 2024)*

Medical History/Disabilities/Illnesses (Including ADD/ADHD, Dyslexia, Behavioral Disorders)*

Special Needs*

Allergies*

Medications *

Religion Class Day & Time:*

Weekly Activities Day & Time:*

Pre-Pointe (Y/N) 9 yo. & up:*

Hip Hop (Y/N) 1st grade & up:*

Previous years of dance:*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

School*

Grade Level (entering in August 2024)*

Medical History/Disabilities/Illnesses (Including ADD/ADHD, Dyslexia, Behavioral Disorders)*

Special Needs*

Allergies*

Medications *

Religion Class Day & Time:*

Weekly Activities Day & Time:*

Pre-Pointe (Y/N) 9 yo. & up:*

Hip Hop (Y/N) 1st grade & up:*

Previous years of dance:*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

School*

Grade Level (entering in August 2024)*

Medical History/Disabilities/Illnesses (Including ADD/ADHD, Dyslexia, Behavioral Disorders)*

Special Needs*

Allergies*

Medications *

Religion Class Day & Time:*

Weekly Activities Day & Time:*

Pre-Pointe (Y/N) 9 yo. & up:*

Hip Hop (Y/N) 1st grade & up:*

Previous years of dance:*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email

School*

Grade Level (entering in August 2024)*

Medical History/Disabilities/Illnesses (Including ADD/ADHD, Dyslexia, Behavioral Disorders)*

Special Needs*

Allergies*

Medications *

Religion Class Day & Time:*

Weekly Activities Day & Time:*

Pre-Pointe (Y/N) 9 yo. & up:*

Hip Hop (Y/N) 1st grade & up:*

Previous years of dance:*

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Questions or Concerns

Comments

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Contact #2

How can we contact you?

Student #1

Additional Info

Student #2 (Show-Hide Details)

Additional Info

Student #3 (Show-Hide Details)

Additional Info

Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

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