Joy in Motion Online Registration

Registration

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Summer Registration Opens 4/25/22 at 10am. All summer classes are 1 payment plan for all. 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 assistance?

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 - '21-'22 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 #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 - '21-'22 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 - '21-'22 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 - '21-'22 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 - '21-'22 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

(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*

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)

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 (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies

(Show-Hide Details)