Raw Dance Limited Online Registration

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Thank you for enrolling with RAW Dance! Your enrollment will be reviewed by our staff and you will be contacted if your selection of classes needs to be discussed.

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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/Prov*

Postal Code*

Primary Phone*

Contact #1

Parent/Guardian #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

Parent/Guardian #2 (Optional) - 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*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please note that all students who register for jazz, hip hop, ballet, tap, musical theatre and contemporary syllabus classes are required to sit examinations in at the end of Term 2. Performances are held at the end of Term 4. Examination fees and show/costume fees are additional to tuition fees. These are billed in term 2 and term 3.

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

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*

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

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*

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class *

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Registration

Referral Information

Family Information

Where do you live?

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

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Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

Additional Info

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Student #4 (Show-Hide Details)

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Additional Info

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