Hit The Floor Dance Studio Online Registration

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Welcome to Hit The Floor Dance Studio! We have something fun for all ages this summer. *Summer classes are nonrefundable.

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Referral Information

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Family Information

Family Last Name*

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Home Address*

City*

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Zip*

Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

Type

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Home Phone

Cell #

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Confirm Email*

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Contact #2

Contact #2 First Name

Last Name

Type

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Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

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Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

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Allergies (Leave blank if NONE)

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Student #3 (Show-Hide Details)

Student's First Name*

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Student Gender*

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Additional Info

Student Email

T-Shirt Size

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Student #4 (Show-Hide Details)

Student's First Name*

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Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

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Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

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Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

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Enroll in Classes

Select Class *

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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

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Student #3 (Show-Hide Details)

Additional Info

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