Dance Arts of Rocky Mount Online Registration

Registration

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Welcome to Dance Arts of Rocky Mount!

Please take a few minutes and register your family, register each participating dance student, and signup for their classes or camps. Once your family is registered you will be able to login to the portal to make payments, check balances, etc. When registering for summer camps or classes you will be charged a $25 registration fee. The registration fee is charged to hold your student's spot in the class or camp.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Costume Option? 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

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?

Home Phone

Work #

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies (Leave blank if NONE)

Years danced here (2023-24)?*

Sibling/Close Relative Dancing

Please click on the Select Class button below to sign your student for classes or camps.

Class/camp enrollment is required at time of web portal signup!

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies (Leave blank if NONE)

Years danced here (2023-24)?*

Sibling/Close Relative Dancing

Please click on the Select Class button below to sign your student for classes or camps.

Class/camp enrollment is required at time of web portal signup!

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies (Leave blank if NONE)

Years danced here (2023-24)?*

Sibling/Close Relative Dancing

Please click on the Select Class button below to sign your student for classes or camps.

Class/camp enrollment is required at time of web portal signup!

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies (Leave blank if NONE)

Years danced here (2023-24)?*

Sibling/Close Relative Dancing

Please click on the Select Class button below to sign your student for classes or camps.

Class/camp enrollment is required at time of web portal signup!

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Allergies (Leave blank if NONE)

Years danced here (2023-24)?*

Sibling/Close Relative Dancing

Please click on the Select Class button below to sign your student for classes or camps.

Class/camp enrollment is required at time of web portal signup!

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

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)