CenterStage Performing Arts Academy Online Registration

Registration

Already a customer? Click here to login.

Registration fees are $55 per family, per year, and are due upon completion of this form. Registration fees are not refundable. Tuition fees are due by the 20th of the month prior to your start date. All fees may be paid by cash, check, or card. Tuition is considered late by the 21st, and all accounts will be charged a $10.00 late fee. If an account is not paid after the 25th, the fees (including the late fee and any other balance) will automatically go to auto draft. No exceptions.

* denotes required fields

Referral Information

How did you hear about us?*

Address Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Contact #1

Contact First Name*

Last Name *

Relationship to Student*

How Can We Contact You?

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from CenterStage Performing Arts Academy. 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

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

School

Disabilities (Leave blank if NONE)*

Special Needs, Allergies, and/or Medications*

Allergies (Leave blank if NONE)*

Medications (Leave blank if NONE)*

Dance Experience*

Are you a graduating Senior?*

Enrolled in school theatre?*

Enrolled in school choir?*

Enrolled in school dance team?*

*We ask the above questions to help us coordinate schedules.

Please use the placement recommendations you have received to enroll in the classes below. If you have not received placement information or have questions about placement, please contact CenterStage before enrolling at info@performcenterstage.com. Please note that on this form, you will only be shown classes available to the student based on his/her age.

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

Disabilities (Leave blank if NONE)*

Special Needs, Allergies, and/or Medications*

Allergies (Leave blank if NONE)*

Medications (Leave blank if NONE)*

Dance Experience*

Are you a graduating Senior?*

Enrolled in school theatre?*

Enrolled in school choir?*

Enrolled in school dance team?*

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

Disabilities (Leave blank if NONE)*

Special Needs, Allergies, and/or Medications*

Allergies (Leave blank if NONE)*

Medications (Leave blank if NONE)*

Dance Experience*

Are you a graduating Senior?*

Enrolled in school theatre?*

Enrolled in school choir?*

Enrolled in school dance team?*

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

Disabilities (Leave blank if NONE)*

Special Needs, Allergies, and/or Medications*

Allergies (Leave blank if NONE)*

Medications (Leave blank if NONE)*

Dance Experience*

Are you a graduating Senior?*

Enrolled in school theatre?*

Enrolled in school choir?*

Enrolled in school dance team?*

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

Disabilities (Leave blank if NONE)*

Special Needs, Allergies, and/or Medications*

Allergies (Leave blank if NONE)*

Medications (Leave blank if NONE)*

Dance Experience*

Are you a graduating Senior?*

Enrolled in school theatre?*

Enrolled in school choir?*

Enrolled in school dance team?*

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

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*

Jackrabbit Technologies' class management platform & registration portal is trusted by 1000s of
dance studios , gyms , swim schools , music schools , cheer gyms , childcare centers , and more .

Registration

Referral Information

Address Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

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

(Show-Hide Details)