New Castle Dance and Music Academy Online Registration

Registration

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Welcome to New Castle Dance & Music Academy's Parent Portal

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family/Billing Name Last Name*

Where do you live?

Home Address*

City*

State

Zip

Primary Phone*

Additional Info

Emergency Contact Info

Student 1 Date of Birth

Contact #1

Contact #1 First Name*

Last Name *

Type

How Can We Contact You?

Home Phone *

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Birth Date*

Additional Info

Student Email

T-Shirt Size

Physical or Learning Conditions*

Allergies (Leave blank if NONE)

Classes should be chosen based on age and/or skill level.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Student Email

T-Shirt Size

Physical or Learning Conditions*

Allergies (Leave blank if NONE)

Classes should be chosen based on age and/or skill level.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Student Email

T-Shirt Size

Physical or Learning Conditions*

Allergies (Leave blank if NONE)

Classes should be chosen based on age and/or skill level.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Student Email

T-Shirt Size

Physical or Learning Conditions*

Allergies (Leave blank if NONE)

Classes should be chosen based on age and/or skill level.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Student Email

T-Shirt Size

Physical or Learning Conditions*

Allergies (Leave blank if NONE)

Classes should be chosen based on age and/or skill level.

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Please fill out ONE of the following Payment Methods

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)

Who is your employer?

Contact #2

How can we contact you?

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

Required Policies

(Show-Hide Details)