Xtreme Dance Academy Online Registration

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Thank you for registering for our 21st dance season! WE are very excited to have you! Please be on the look out for a welcome email from our staff! If you have any questions at any point please let us know!! Be sure to visit us on August 24th 10:00AM -2:00 PM at our Open House/Meet The Teacher!

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Referral Information

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Photo Release Agreement*

Contact #1

Contact #1 First Name*

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Type*

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Cell # *

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Contact #2

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Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Disabilities (Any medical conditions XDA should be aware of?)

Special Needs

Allergies (Leave black in NONE)

Medications (Leave blank if NONE)

Thank you for registering for our 21st dance season! WE are very excited to have you! Please be on the look out for a welcome email from our staff!
If you have any questions at any point please let us know!!
Be sure to visit us on August 24th 10:00AM -2:00 PM at our Open House/Meet The Teacher!

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Disabilities (Any medical conditions XDA should be aware of?)

Special Needs

Allergies (Leave black in NONE)

Medications (Leave blank if NONE)

Thank you for registering for our 21st dance season! WE are very excited to have you! Please be on the look out for a welcome email from our staff!
If you have any questions at any point please let us know!!
Be sure to visit us on August 24th 10:00AM -2:00 PM at our Open House/Meet The Teacher!

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Disabilities (Any medical conditions XDA should be aware of?)

Special Needs

Allergies (Leave black in NONE)

Medications (Leave blank if NONE)

Thank you for registering for our 21st dance season! WE are very excited to have you! Please be on the look out for a welcome email from our staff!
If you have any questions at any point please let us know!!
Be sure to visit us on August 24th 10:00AM -2:00 PM at our Open House/Meet The Teacher!

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Disabilities (Any medical conditions XDA should be aware of?)

Special Needs

Allergies (Leave black in NONE)

Medications (Leave blank if NONE)

Thank you for registering for our 21st dance season! WE are very excited to have you! Please be on the look out for a welcome email from our staff!
If you have any questions at any point please let us know!!
Be sure to visit us on August 24th 10:00AM -2:00 PM at our Open House/Meet The Teacher!

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

Disabilities (Any medical conditions XDA should be aware of?)

Special Needs

Allergies (Leave black in NONE)

Medications (Leave blank if NONE)

Thank you for registering for our 21st dance season! WE are very excited to have you! Please be on the look out for a welcome email from our staff!
If you have any questions at any point please let us know!!
Be sure to visit us on August 24th 10:00AM -2:00 PM at our Open House/Meet The Teacher!

Enroll in Classes

Select Class

Add Another Student

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Registration

Referral Information

Family Information

Where do you live?

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