Kings Dance Center Online Registration

Registration

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KDC Registration - Please provide your information below and click submit when complete. Credit cards are NOT charged at this time. All enrollments are considered pending until we have reviewed your registration and posted any fees due. Applicable discounts will be applied as well.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name*

Family Information

Family Last Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

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

Contact #2 First Name

Last Name

Type*

How can we contact you?

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

Disabilites

Special Needs

Allergies

Medications

Choose any filter to begin viewing available classes.

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

Disabilites

Special Needs

Allergies

Medications

Choose any filter to begin viewing available classes.

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

Disabilites

Special Needs

Allergies

Medications

Choose any filter to begin viewing available classes.

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

Disabilites

Special Needs

Allergies

Medications

Choose any filter to begin viewing available classes.

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

Disabilites

Special Needs

Allergies

Medications

Choose any filter to begin viewing available classes.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Summer Payment Agreement

I understand my registration will be reviewed and any fees due/applicable discounts will be posted to my account within 48 hours of submitting my registration. At that time my credit card will be charged for the full amount due. I understand I may contact KDC by phone or email if I have any billing questions.
Tuition adjustments will not be made for missed classes.

I've read the above and agree.

Liability Release

It is expressly agreed that all use of the Kings Dance Center (KDC) shall be undertaken by a student at his/her sole risk and studio shall not be liable for any injuries or damages to any student or property of any student, nor will KDC, their instructors and assigns be subject to any claim, demand, injuries or damages whatsoever by any student. The student, for himself/herself and on behalf of his executors, administrators, and assigns, does hereby forever release and discharge KDC, their successors and assigns, as well as their instructors, owner and staff from all such claims, injuries, damages, action or causes of action. I have reviewed the student & parent handbook online and agree to all regulations and policies set forth by KDC.

I've read the above and agree.

Photo/Video Release

I hereby consent to and authorize the reproduction, publication, and/any other use by Kings Dance Center and grant permission to the rights of my dancer(s) image, likeness, and sound of my dancer(s) voice as recorded on audio- or videotape without payment or any other consideration. I understand that my dancer(s) image may be edited, copied, exhibited, published, or distributed and I waive the right to inspect or approve the finished product wherein my dancer(s) likeness appears. Additionally, I waive any right to royalties or other compensation arising from or related to the use of my image or recording. I also understand that this material may be used for any lawful purpose, including illustration, promotion, advertising, web content, and television.

By signing this release I understand that this permission signifies that photographic or video recordings of me or my dancer(s) may be electronically displayed via the Internet or in the public setting. There is no time limit on the validity of this release, nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio, or video recordings collected as part of KDC classes, rehearsals, or performances. By signing this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

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*