En Avant School of Dance Online Registration

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En Avant School of Dance On-Line Registration

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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*

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 # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from En Avant School of Dance. Standard message and data rates apply. Reply STOP to opt out

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 # * Receive Text Message Notifications. By opting in, you agree to receive SMS messages from En Avant School of Dance. Standard message and data rates apply. Reply STOP to opt out

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*

Additional Info

Student Email

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Please schedule an appointment for shoe/dance-wear fittings by August 25th. Returning students should bring their dance bag and all their shoes from last year.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Please schedule an appointment for shoe/dance-wear fittings by August 25th. Returning students should bring their dance bag and all their shoes from last year.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Please schedule an appointment for shoe/dance-wear fittings by August 25th. Returning students should bring their dance bag and all their shoes from last year.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Please schedule an appointment for shoe/dance-wear fittings by August 25th. Returning students should bring their dance bag and all their shoes from last year.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School*

Grade Level*

Disabilities*

Special Needs*

Allergies*

Please schedule an appointment for shoe/dance-wear fittings by August 25th. Returning students should bring their dance bag and all their shoes from last year.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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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*

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

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

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