Dance Theater of New England Online Registration

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Dance Theater of New England 25 Scotland BLVD #2 Bridgewater, MA 02324

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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*

Home or Primary Phone*

Additional Info

Emergency Contact Info

New To DTNE*

Returning Student*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work # *

Cell # * Receive Text Message Notifications

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

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Home Phone

Work #

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies*

Medications (Leave blank if NONE)

Enroll in Classes

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies*

Medications (Leave blank if NONE)

Enroll in Classes

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Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies*

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies*

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies*

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Assumption of Risk and Waiver

I am enrolling my child(ren) in Dance Theater of New England for the 2019-2020 season. I fully understand that participants in dance programs, recitals and dance competitions take certain risks including minimal, serious and catastrophic injuries. I acknowledge and accept such risks and release the staff and faculty of Dance Theater of New England, Reverence Enterprises, LLC, its Directors and Owners from any claims of damages, injuries or loss of property while participationg in classes at Dance Theater of New England, their recitals or other studio sponsored events. Also, I have read and understand all rules and regulations and will fully comply with these rules and regulations. I also acknowledge that my child(ren) is in sound health and is able to participate in rigorous physical activities.