Studio Dance Inc Online Registration

Registration

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Summer 2020 class registration is open. A $25 deposit is required to reserve spot and applied to total cost, 2020 -21 Fall Class schedule is posted and open for registration now! A $25 deposit must be paid in order to secure a spot in the class. This is non-refundable.

* 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*

Home or Primary Phone*

Additional Info

Emergency Contact Info<br/>(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

T-Shirt Size

School*

Grade Level*

Disabilities*

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

T-Shirt Size

School*

Grade Level*

Disabilities*

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

T-Shirt Size

School*

Grade Level*

Disabilities*

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

T-Shirt Size

School*

Grade Level*

Disabilities*

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

T-Shirt Size

School*

Grade Level*

Disabilities*

Allergies*

Medications*

Enroll in Classes

Select Class

Add Another Student