Elite Dance Academy Online Registration

Registration

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Welcome to Elite Dance Academy! Registration requires a credit/debit card & email address on file. Please complete the form below to enroll in classes. To enroll in events click on "submit registration" below, then visit our website, click on "Family Portal" and log in. Click on "Classes & Events" and follow prompts to complete registration. If you have any questions, please contact us at info@elitedanceil.com.

* denotes required fields

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*

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

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*

Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Special Needs (leave blank if none)

Allergies (leave blank if none)

Class ages & grades are as of 9/1/2021. If your dancer will be in 4th grade or above on 9/1/2021, please enroll in Debut classes. Dancers will be evaluated during their classes for further placement. Premiere and Level classes are by teacher placement only.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Special Needs (leave blank if none)

Allergies (leave blank if none)

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Special Needs (leave blank if none)

Allergies (leave blank if none)

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Special Needs (leave blank if none)

Allergies (leave blank if none)

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School*

Grade Level*

Special Needs (leave blank if none)

Allergies (leave blank if none)

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

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*

Jackrabbit Technologies' class management platform & registration portal is trusted by 1000s of
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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)

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

Credit Card

Required Policies

(Show-Hide Details)