Chehalem Valley Dance Academy Online Registration

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from Chehalem Valley Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies

Medications (Leave blank if NONE)

Primary Doctor

All summer camps are age based only and not skilled based.

All classes above beginning level are by placement only. Please visit iheartcvda.com/free-trial to book a free trial for placement. Company classes are for those dancers in the group only. Adult classes can also include teens with permission from instructor.

Tuition is calculated by class. Each dancer will get a discount on their 2nd, 3rd, and 4th class. We will review registrations and notify you of any changes that need to be made. Our tuition info and policies, dress code, and all other important info is on our website at iheartvda.com.

Thank you so much for enrolling at CVDA!

Newberg Location Address 311 E 1st, Newberg, OR 97132

McMinnville Location Address 822 SE 1st St, McMinnville, OR 97128 (in the Boho Building)

-CVDA Team

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from Chehalem Valley Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies

Medications (Leave blank if NONE)

Primary Doctor

All summer camps are age based only and not skilled based.

All classes above beginning level are by placement only. Please visit iheartcvda.com/free-trial to book a free trial for placement. Company classes are for those dancers in the group only. Adult classes can also include teens with permission from instructor.

Tuition is calculated by class. Each dancer will get a discount on their 2nd, 3rd, and 4th class. We will review registrations and notify you of any changes that need to be made. Our tuition info and policies, dress code, and all other important info is on our website at iheartvda.com.

Thank you so much for enrolling at CVDA!

Newberg Location Address 311 E 1st, Newberg, OR 97132

McMinnville Location Address 822 SE 1st St, McMinnville, OR 97128 (in the Boho Building)

-CVDA Team

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from Chehalem Valley Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies

Medications (Leave blank if NONE)

Primary Doctor

All summer camps are age based only and not skilled based.

All classes above beginning level are by placement only. Please visit iheartcvda.com/free-trial to book a free trial for placement. Company classes are for those dancers in the group only. Adult classes can also include teens with permission from instructor.

Tuition is calculated by class. Each dancer will get a discount on their 2nd, 3rd, and 4th class. We will review registrations and notify you of any changes that need to be made. Our tuition info and policies, dress code, and all other important info is on our website at iheartvda.com.

Thank you so much for enrolling at CVDA!

Newberg Location Address 311 E 1st, Newberg, OR 97132

McMinnville Location Address 822 SE 1st St, McMinnville, OR 97128 (in the Boho Building)

-CVDA Team

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from Chehalem Valley Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies

Medications (Leave blank if NONE)

Primary Doctor

All summer camps are age based only and not skilled based.

All classes above beginning level are by placement only. Please visit iheartcvda.com/free-trial to book a free trial for placement. Company classes are for those dancers in the group only. Adult classes can also include teens with permission from instructor.

Tuition is calculated by class. Each dancer will get a discount on their 2nd, 3rd, and 4th class. We will review registrations and notify you of any changes that need to be made. Our tuition info and policies, dress code, and all other important info is on our website at iheartvda.com.

Thank you so much for enrolling at CVDA!

Newberg Location Address 311 E 1st, Newberg, OR 97132

McMinnville Location Address 822 SE 1st St, McMinnville, OR 97128 (in the Boho Building)

-CVDA Team

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from Chehalem Valley Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies

Medications (Leave blank if NONE)

Primary Doctor

All summer camps are age based only and not skilled based.

All classes above beginning level are by placement only. Please visit iheartcvda.com/free-trial to book a free trial for placement. Company classes are for those dancers in the group only. Adult classes can also include teens with permission from instructor.

Tuition is calculated by class. Each dancer will get a discount on their 2nd, 3rd, and 4th class. We will review registrations and notify you of any changes that need to be made. Our tuition info and policies, dress code, and all other important info is on our website at iheartvda.com.

Thank you so much for enrolling at CVDA!

Newberg Location Address 311 E 1st, Newberg, OR 97132

McMinnville Location Address 822 SE 1st St, McMinnville, OR 97128 (in the Boho Building)

-CVDA Team

Enroll in Classes

Select Class *

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)

Contact #2

How can we contact you?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

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Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies

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I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

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)

Contact #2

How can we contact you?

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

eCheck/Bank Draft

Required Policies

(Show-Hide Details)