Kerri's Dance Studio Online Registration

Registration

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Kerri's Dance Studio 2019-2020

* 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*

Home or Primary Phone*

Additional Info

Contact #1

Parent First Name*

Last Name *

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* (format=mm/dd/yyyy)

Additional Info

Special Needs (Leave blank if NONE)

There is a $25.00 single student registration fee due at this time. There is an additional $5.00 registration fee for each additional student.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Special Needs (Leave blank if NONE)

There is a $25.00 single student registration fee due at this time. There is an additional $5.00 registration fee for each additional student.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Special Needs (Leave blank if NONE)

There is a $25.00 single student registration fee due at this time. There is an additional $5.00 registration fee for each additional student.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Special Needs (Leave blank if NONE)

There is a $25.00 single student registration fee due at this time. There is an additional $5.00 registration fee for each additional student.

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

Special Needs (Leave blank if NONE)

There is a $25.00 single student registration fee due at this time. There is an additional $5.00 registration fee for each additional student.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Monthly lesson fees

I understand that monthly lesson fees are the same every month from September through May regardless of the number of lessons in the month. I understand I will be charged for lessons, whether I attend them or not, until paper work is filled out with KDS in regards to dropping a class. I understand that monthly lesson fees are due to the KDS office by the end of business on the 15th day of every month. If lesson fees have not been paid or received by the 20th day of each month a $10.00 late fee will be applied to the account. I understand lesson fees are NON REFUNDABLE OR TRANSFERABLE unless due to a documented medical problem.