The Dancing Lights Ballet School Online Registration

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Contact #1

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Student #1

Student's First Name*

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Additional Info

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Please Note: There is a annual $25 Registration Fee per family.

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Student #2 (Show-Hide Details)

Student's First Name*

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Student Email

T-Shirt Size

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Grade Level

Disabilities (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please Note: There is a annual $25 Registration Fee per family.

Enroll in Classes

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Additional Info

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T-Shirt Size

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Grade Level

Disabilities (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please Note: There is a annual $25 Registration Fee per family.

Enroll in Classes

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Student #4 (Show-Hide Details)

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Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please Note: There is a annual $25 Registration Fee per family.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Please Note: There is a annual $25 Registration Fee per family.

Enroll in Classes

Select Class

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Exp Year *

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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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

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