Studio Dance Inc Online Registration

Registration

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Summer Registration : A $25 deposit is due to secure your spot. This fee is NOT REFUNDABLE and will not be posted to your Parent Portal until we receive your enrollment notice. Watch your Portal and Email! The remainder of the cost of the class will be due on the day of the first class. 2018-2019 Fall Registration: Online registration open on Wednesday, May 23, 2018!! There is a $25 registration fee for all students this year.

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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*

Home or Primary Phone*

Additional Info

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

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*

(format=mm/dd/yyyy)

Cell #

Additional Info

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Cell #

Additional Info

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Cell #

Additional Info

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Cell #

Additional Info

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Cell #

Additional Info

School*

Grade Level*

Disabilites*

Allergies*

Medications*

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Responsibility Policy

I understand and acknowledge that participation in dance and tumbling can be hazardous and realize that no one should ever enter this activity unless they are in good medical condition. I assume all risk and will indemnify and hold harmless Studio Dance, Inc. for any injury or claim associated with this activity. I fully understand that it is my responsibility for the well being of my child/children when they are in the studio lobby, bathroom, or outside the studio.