Dance Force, LLC Online Registration

Registration

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CLASS REGISTRATION IS FOR NEW FAMILIES, RETURNING FAMILIES SHOULD REGISTER THROUGH THE PARENT PORTAL Class space is limited so we must develop an accurate list of students in order to create classes. It is also very important to us that we do not exceed a desired amount of students per class. Advance registration will guarantee your child’s dance space. The Registration Fee is to reserve your child’s spot in a class.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name*

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

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?

Home Phone

Work #

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Force, LLC. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size

School

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications (Leave blank if NONE)

Primary Doctor*

Immunization Notes

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

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*

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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

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

Credit Card

Required Policies

(Show-Hide Details)