Clarion Dance and Tumbling Academy Online Registration

Registration

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Use this online registration form to select your classes, review schedules, and reserve your spot. Please read through the class descriptions and policies carefully before submitting your registration. Spaces are limited and tend to fill quickly, so early registration is encouraged!

* denotes required fields

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)*

Health Insurance Carrier*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Clarion Dance and Tumbling Academy. 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

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

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

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Birth Date*

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

Additional Info

Student Email

T-Shirt Size

Allergies (Leave blank if NONE)

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

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

Additional Info

Student Email

T-Shirt Size

Allergies (Leave blank if NONE)

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

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

Additional Info

Student Email

T-Shirt Size

Allergies (Leave blank if NONE)

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

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

Additional Info

Student Email

T-Shirt Size

Allergies (Leave blank if NONE)

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

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

Additional Info

Student Email

T-Shirt Size

Allergies (Leave blank if NONE)

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*

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Registration

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

Credit Card

Required Policies

(Show-Hide Details)