Letha Fulton School of Dance Online Registration

Registration

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Hi LFSD Families! We are grateful you have chosen LFSD, and are part of our family. Please fill out all information in entirety and sign all waiver information. Class participation WILL NOT be allowed until your portal set-up is complete. Please become comfortable using your portal as your student class information, account balances and more will be updated on this feature. For more info, visit our website, email or call. We love to help.

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Referral Information

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Referral Name*

Family Information

Family Last Name*

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Home Address*

City*

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Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Health Insurance Carrier

Contact #1

Contact #1 First Name*

Last Name *

Type*

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Home Phone *

Work #

Cell # Receive Text Message Notifications

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

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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 # 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*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

SDS Texting Policies for Letha Fulton School of Dance
Texting Capabilities are Coming Very Soon - Sign Up Now to be Ready!

By selecting the box "Receive Text Message Notifications" on this form, you are agreeing to our Informed Consent for Text (SMS) Messaging terms, conditions and privacy policies, located HERE.

You will give consent to Letha Fulton School of Dance to send occasional text messages regarding class changes, business closings, upcoming events, and account notifications.

For help, reply HELP. Reply STOP to unsubscribe.

Standard messages and data rates may apply.

Please consider adding Letha Fulton School of Dance Texting Numbers; (231) 300-844 and (231) 300-8483 as a contact in your phone, so that our text messages will not go to spam.

Participation in our text (SMS) messaging service is entirely voluntary. You have the right to refuse or withdraw your consent at any time.

Letha Fulton School of Dance does not sell, share or trade our customers/users phone numbers.

-Letha Fulton School of Dance

For Classes: Make sure your student(s) is dressed in appropriate attire for class and their hair is pulled back. Please take a look at our website for more information.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

SDS Texting Policies for Letha Fulton School of Dance
Texting Capabilities are Coming Very Soon - Sign Up Now to be Ready!

By selecting the box "Receive Text Message Notifications" on this form, you are agreeing to our Informed Consent for Text (SMS) Messaging terms, conditions and privacy policies, located HERE.

You will give consent to Letha Fulton School of Dance to send occasional text messages regarding class changes, business closings, upcoming events, and account notifications.

For help, reply HELP. Reply STOP to unsubscribe.

Standard messages and data rates may apply.

Please consider adding Letha Fulton School of Dance Texting Numbers; (231) 300-844 and (231) 300-8483 as a contact in your phone, so that our text messages will not go to spam.

Participation in our text (SMS) messaging service is entirely voluntary. You have the right to refuse or withdraw your consent at any time.

Letha Fulton School of Dance does not sell, share or trade our customers/users phone numbers.

-Letha Fulton School of Dance

For Classes: Make sure your student(s) is dressed in appropriate attire for class and their hair is pulled back. Please take a look at our website for more information.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

SDS Texting Policies for Letha Fulton School of Dance
Texting Capabilities are Coming Very Soon - Sign Up Now to be Ready!

By selecting the box "Receive Text Message Notifications" on this form, you are agreeing to our Informed Consent for Text (SMS) Messaging terms, conditions and privacy policies, located HERE.

You will give consent to Letha Fulton School of Dance to send occasional text messages regarding class changes, business closings, upcoming events, and account notifications.

For help, reply HELP. Reply STOP to unsubscribe.

Standard messages and data rates may apply.

Please consider adding Letha Fulton School of Dance Texting Numbers; (231) 300-844 and (231) 300-8483 as a contact in your phone, so that our text messages will not go to spam.

Participation in our text (SMS) messaging service is entirely voluntary. You have the right to refuse or withdraw your consent at any time.

Letha Fulton School of Dance does not sell, share or trade our customers/users phone numbers.

-Letha Fulton School of Dance

For Classes: Make sure your student(s) is dressed in appropriate attire for class and their hair is pulled back. Please take a look at our website for more information.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

SDS Texting Policies for Letha Fulton School of Dance
Texting Capabilities are Coming Very Soon - Sign Up Now to be Ready!

By selecting the box "Receive Text Message Notifications" on this form, you are agreeing to our Informed Consent for Text (SMS) Messaging terms, conditions and privacy policies, located HERE.

You will give consent to Letha Fulton School of Dance to send occasional text messages regarding class changes, business closings, upcoming events, and account notifications.

For help, reply HELP. Reply STOP to unsubscribe.

Standard messages and data rates may apply.

Please consider adding Letha Fulton School of Dance Texting Numbers; (231) 300-844 and (231) 300-8483 as a contact in your phone, so that our text messages will not go to spam.

Participation in our text (SMS) messaging service is entirely voluntary. You have the right to refuse or withdraw your consent at any time.

Letha Fulton School of Dance does not sell, share or trade our customers/users phone numbers.

-Letha Fulton School of Dance

For Classes: Make sure your student(s) is dressed in appropriate attire for class and their hair is pulled back. Please take a look at our website for more information.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

SDS Texting Policies for Letha Fulton School of Dance
Texting Capabilities are Coming Very Soon - Sign Up Now to be Ready!

By selecting the box "Receive Text Message Notifications" on this form, you are agreeing to our Informed Consent for Text (SMS) Messaging terms, conditions and privacy policies, located HERE.

You will give consent to Letha Fulton School of Dance to send occasional text messages regarding class changes, business closings, upcoming events, and account notifications.

For help, reply HELP. Reply STOP to unsubscribe.

Standard messages and data rates may apply.

Please consider adding Letha Fulton School of Dance Texting Numbers; (231) 300-844 and (231) 300-8483 as a contact in your phone, so that our text messages will not go to spam.

Participation in our text (SMS) messaging service is entirely voluntary. You have the right to refuse or withdraw your consent at any time.

Letha Fulton School of Dance does not sell, share or trade our customers/users phone numbers.

-Letha Fulton School of Dance

For Classes: Make sure your student(s) is dressed in appropriate attire for class and their hair is pulled back. Please take a look at our website for more information.

Enroll in Classes

Select Class *

Add Another Student

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Exp Year *

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Name as it appears on card *

Address Line 1

Address Line 2

City

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Zip*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

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Account Number

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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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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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Questions or Concerns

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eCheck/Bank Draft

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