*Payment details are required to secure all trial classes with Dance Republic however no payment will be processed until you have confirmed that you would like to continue with classes after your trial

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Family Information
Where do you live?
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
(Emails are kept confidential)
Who is your employer?
Contact #2
How can we contact you?
(Emails are kept confidential)
Who is your employer?
Student #1
Additional Info

Kids Program: Students are to wear any comfortable clothes until their uniform is given to them in class. We suggest all students bring a labelled water bottle to class and a healthy snack for before class or during a break. Walking Bus students meet at the Kindy bench furthest from the Hall. Please ensure you notify us if your child will be absent from the Walking Bus to avoid confusion and delays transferring students to the studio.

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Required Policies and Agreements
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Questions or Concerns
Payment Information
Please fill out ONE of the following Payment Methods
Credit Card
eCheck/Bank Draft
(Your name on your bank statement)
(6-digit number)