Registration


SYNERGY DANCE ACADEMY

*   denotes required fields

Referral Information
Family Information
Where do you live?
Click to Enter an International Number
Additional Info
Contact #1
How Can We Contact You?
Click to Enter an International Number
Click to Enter an International Number
Click to Enter an International Number
Portal Access (your email is your login)
(Emails are kept confidential)
Contact #2
How can we contact you?
Click to Enter an International Number
Click to Enter an International Number
Click to Enter an International Number
(Emails are kept confidential)
Student #1
(format=mm/dd/yyyy)
Click to Enter an International Number
Additional Info

Welcome to online registration! Note that we require a valid email address and phone number for your online registration, in order that you can have an account on our customer portal.

Enroll in Classes
Select Class *
Required Policies and Agreements
I Agree to All of the Above
Questions or Concerns
Payment Information
Account Information
Please fill out CREDIT CARD Payment Method
Credit Card
eCheck/Bank Draft
(Your name on your bank statement)
(9-digit number)