AKA Dance LLC Online Registration

Registration

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Welcome to AKA Dance!

* 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 (Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Home Phone *

Work #

Cell # *

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

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*

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

Additional Info

Student Email

Special Needs (Leave blank if NONE)

Allergies

Please provide your information below and click SAVE when complete. You must supply a valid credit card in order to register. New families will pay a one-time registration fee of $45.

The summer class fees will be charged in full on July 7th, 2026 using the card you have on file. If you prefer you may pay manually at the time of registration.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if NONE)

Allergies

Please provide your information below and click SAVE when complete. You must supply a valid credit card in order to register. New families will pay a one-time registration fee of $45.

The summer class fees will be charged in full on July 7th, 2026 using the card you have on file. If you prefer you may pay manually at the time of registration.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if NONE)

Allergies

Please provide your information below and click SAVE when complete. You must supply a valid credit card in order to register. New families will pay a one-time registration fee of $45.

The summer class fees will be charged in full on July 7th, 2026 using the card you have on file. If you prefer you may pay manually at the time of registration.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if NONE)

Allergies

Please provide your information below and click SAVE when complete. You must supply a valid credit card in order to register. New families will pay a one-time registration fee of $45.

The summer class fees will be charged in full on July 7th, 2026 using the card you have on file. If you prefer you may pay manually at the time of registration.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if NONE)

Allergies

Please provide your information below and click SAVE when complete. You must supply a valid credit card in order to register. New families will pay a one-time registration fee of $45.

The summer class fees will be charged in full on July 7th, 2026 using the card you have on file. If you prefer you may pay manually at the time of registration.

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
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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)

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)