Joy in Motion Online Registration

Registration

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Dance for Joy! YOUTH registration for Winter Spring 2018 Session is closed. Summer 2018 registration is open! ADULT HIP HOP for WinterSpring2018 - please create a student with your own name & select the class card you wish to purchase as your "class". If you have questions, please email us at joy@joyinmotiondance.org

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Account Last Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
Who should we call 1st? You may also add more Emergency contacts here*

Health Insurance/Hospital*

Vet/Enlisted/1st Responder?

Need tuition assitance?

Contact #1

Adult Contact #1 First Name*

Last Name *

Relation to Student(s)*

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

Adult Contact #2 First Name*

Last Name*

Relation to Student(s)*

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

Student Email

School

Grade Level (completed if summer)*

Physical Limitations Useful for a Dance Teacher to Know About

Specific Classroom Needs/Challenges

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired

Medications We May Need to Know About

Danced before but never with Justin or Ms. Linda? Please describe previous dance experience.

Does he/she go by a nickname?

Use the search button on this form to find classes. Please Note: YOUTH prices listed are for the full session. All summer classes are billed in full session only. If you select 2 payments or 4 payments (monthly), that payment plan will be used for the regular school year sessions at Joy in Motion.

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

Student Email

School

Grade Level (completed if summer)*

Physical Limitations Useful for a Dance Teacher to Know About

Specific Classroom Needs/Challenges

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired

Medications We May Need to Know About

Danced before but never with Justin or Ms. Linda? Please describe previous dance experience.

Does he/she go by a nickname?

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

Student Email

School

Grade Level (completed if summer)*

Physical Limitations Useful for a Dance Teacher to Know About

Specific Classroom Needs/Challenges

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired

Medications We May Need to Know About

Danced before but never with Justin or Ms. Linda? Please describe previous dance experience.

Does he/she go by a nickname?

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

Student Email

School

Grade Level (completed if summer)*

Physical Limitations Useful for a Dance Teacher to Know About

Specific Classroom Needs/Challenges

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired

Medications We May Need to Know About

Danced before but never with Justin or Ms. Linda? Please describe previous dance experience.

Does he/she go by a nickname?

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

Student Email

School

Grade Level (completed if summer)*

Physical Limitations Useful for a Dance Teacher to Know About

Specific Classroom Needs/Challenges

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired

Medications We May Need to Know About

Danced before but never with Justin or Ms. Linda? Please describe previous dance experience.

Does he/she go by a nickname?

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Payment Policy

We require each family to provide a current VISA or DISCOVER or MASTERCARD, which will be automatically charged on the due date(s). You may pay by check or cash, if payment is provided by one week before the due date(s). In the event a credit card cannot be processed and a payment is more than 30 days overdue, your account will be charged an additional $35 late fee. By agreeing to Joy in Motion's payment policy, you authorize Joy in Motion to automatically charge the card you have on file for the full payment of the payment plan you have selected. Any student whose tuition is in arrears 30 days without any account payments may be asked to stay home.