CenterStage Performing Arts Academy Online Registration

Registration

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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.

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Referral Information

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Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Contact #1

Contact First Name*

Last Name *

Relationship to Student*

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Cell # * Receive Text Message Notifications

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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.

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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

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Registration

Referral Information

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Contact #1

How Can We Contact You?

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Student #1

Additional Info

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