The Premiere Dance & Performing Arts Online Registration

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Welcome to The 2023 -2024 Premiere Dance Season!

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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*

Contact #1

Contact #1 First Name*

Last Name *

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

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Do not hesitate to reach out with any questions. We are here to help you every step of the way. KT@thepremieredance.com Keiana 913-221-9312 Tiffany 913-244-5017

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Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Do not hesitate to reach out with any questions. We are here to help you every step of the way. KT@thepremieredance.com Keiana 913-221-9312 Tiffany 913-244-5017

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Do not hesitate to reach out with any questions. We are here to help you every step of the way. KT@thepremieredance.com Keiana 913-221-9312 Tiffany 913-244-5017

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Do not hesitate to reach out with any questions. We are here to help you every step of the way. KT@thepremieredance.com Keiana 913-221-9312 Tiffany 913-244-5017

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

Do not hesitate to reach out with any questions. We are here to help you every step of the way. KT@thepremieredance.com Keiana 913-221-9312 Tiffany 913-244-5017

Enroll in Classes

Select Class

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Address Line 1

Address Line 2

City

State

Zip

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

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Registration

Referral Information

Family Information

Where do you live?

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

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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Student #4 (Show-Hide Details)

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Additional Info

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Questions or Concerns

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Required Policies

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