Joy in Motion Online Registration

Dance for Joy! Registration for 2021 Winter/Spring #1 -January/February Session starts Tuesday 1/5 at 7pm. Registering as an adult for Adult Classes? Make yourself the both the Adult Contact and the "Student".

* 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<br/>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 - '20-'21 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Danced before but never with Joy in Motion? Please describe previous dance experience.

Does dancer go by a nickname?

For ZOOM Hip Hop/Funky Freedom, we are not going to regulate how many people in your family are dancing in your living room with one registration. Make it a family affair if you want! That being said, if you are wanting/able to pay for additional siblings taking the same class, Hip Hop/Funky Freedom tuition can be half off the 2nd/3rd enrollment in the house if you email us to apply the discount. Register each student separately to pay this tuition fee and reach out to us at www.joyinmotiondance.org

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 - '20-'21 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Danced before but never with Joy in Motion? Please describe previous dance experience.

Does dancer 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 - '20-'21 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Danced before but never with Joy in Motion? Please describe previous dance experience.

Does dancer 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 - '20-'21 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Danced before but never with Joy in Motion? Please describe previous dance experience.

Does dancer 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 - '20-'21 School Year*

Physical Limitations Useful for a Dance Teacher to Know About - Blank if None

Specific Classroom Needs/Challenges - Blank if None

Medical Conditions: i.e. Asthma, Peanut Allergy, Diabetes, Hearing Impaired - Blank if None

Medications We May Need to Know About - Blank if None

Danced before but never with Joy in Motion? Please describe previous dance experience.

Does dancer go by a nickname?

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

Select a Payment Plan*

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*

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 and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies and Agreements

(Show-Hide Details)