5678 Dance! Studio LLC Online Registration

Registration

Already a customer? Click here to login.

Welcome to 5678 Dance! Studio LLC! Please complete the following registration form. ALL SCHOOL YEAR CLASSES are divided by age and experience. All classes marked as Prerequisite Required need to have studio approval before signing up. Please check your parent portal for recommended classes or email us at 5678danceoconomowoc@gmail.com FALL/WINTER CAMPS & SUMMER SESSION will note age and you can sign up for them regardless of level.

* 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*

Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell #

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*

How can we contact you?

Home Phone *

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Birth Date*

Additional Info

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

STUDENTS ENROLLED IN THE 6 WEEK SUMMER SESSION PLEASE CHOOSE T-SHIRT SIZE ABOVE. (Choices: Child X-Small(2-4), Small(6-8), Medium(10-12), Large(14-16) and Adult Small, Medium, Large)

ALL SCHOOL YEAR CLASSES are divided by age and experience. All classes marked as Prerequisite Required need to have studio approval before signing up. Please check your parent portal for recommended classes or email us at 5678danceoconomowoc@gmail.com

FALL/WINTER CAMPS & SUMMER SESSION will note age and you can sign up for them regardless of level.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

STUDENTS ENROLLED IN THE 6 WEEK SUMMER SESSION PLEASE CHOOSE T-SHIRT SIZE ABOVE. (Choices: Child X-Small(2-4), Small(6-8), Medium(10-12), Large(14-16) and Adult Small, Medium, Large)

FALL/WINTER CAMPS & SUMMER SESSION will note age and you can sign up for them regardless of level.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

STUDENTS ENROLLED IN THE 6 WEEK SUMMER SESSION PLEASE CHOOSE T-SHIRT SIZE ABOVE. (Choices: Child X-Small(2-4), Small(6-8), Medium(10-12), Large(14-16) and Adult Small, Medium, Large)

FALL/WINTER CAMPS & SUMMER SESSION will note age and you can sign up for them regardless of level.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

STUDENTS ENROLLED IN THE 6 WEEK SUMMER SESSION PLEASE CHOOSE T-SHIRT SIZE ABOVE. (Choices: Child X-Small(2-4), Small(6-8), Medium(10-12), Large(14-16) and Adult Small, Medium, Large)

FALL/WINTER CAMPS & SUMMER SESSION will note age and you can sign up for them regardless of level.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

STUDENTS ENROLLED IN THE 6 WEEK SUMMER SESSION PLEASE CHOOSE T-SHIRT SIZE ABOVE. (Choices: Child X-Small(2-4), Small(6-8), Medium(10-12), Large(14-16) and Adult Small, Medium, Large)

FALL/WINTER CAMPS & SUMMER SESSION will note age and you can sign up for them regardless of level.

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
dance studios , gyms , swim schools , music schools , cheer gyms , childcare centers , and more .

Registration

Referral Information

Family Information

Where do you live?

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)