The Philadelphia Dance Academy Online Registration

Registration

Already a customer? Click here to login.

Tuition is non-refundable. Please carefully read COVID-19 policies on our homepage before registering. Upon enrollment, The Philadelphia Dance Academy will auto charge your credit card on file a $25 non-refundable Annual Registration Fee (school year only). The First Tuition Installment is auto charged on Aug 15 or at the time of enrollment after Aug 15. The Second Tuition Installment is auto charged on Jan 15.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell # *

Email* (Emails are kept confidential)

Confirm Email*

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

Academic School*

Grade Level*

Transportation

Disabilities*

Special Needs*

Allergies*

Medications*

Immunization Notes*

Previous Dance School*

Previous Dance Training*

Additional Notes?

The system will automatically display classes that are available based on your child's age.

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

Academic School*

Grade Level*

Transportation

Disabilities*

Special Needs*

Allergies*

Medications*

Immunization Notes*

Previous Dance School*

Previous Dance Training*

Additional Notes?

The system will automatically display classes that are available based on your child's age.

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

Academic School*

Grade Level*

Transportation

Disabilities*

Special Needs*

Allergies*

Medications*

Immunization Notes*

Previous Dance School*

Previous Dance Training*

Additional Notes?

The system will automatically display classes that are available based on your child's age.

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

Academic School*

Grade Level*

Transportation

Disabilities*

Special Needs*

Allergies*

Medications*

Immunization Notes*

Previous Dance School*

Previous Dance Training*

Additional Notes?

The system will automatically display classes that are available based on your child's age.

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

Academic School*

Grade Level*

Transportation

Disabilities*

Special Needs*

Allergies*

Medications*

Immunization Notes*

Previous Dance School*

Previous Dance Training*

Additional Notes?

The system will automatically display classes that are available based on your child's age.

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

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

Required Policies

(Show-Hide Details)