THE INDUSTRY Dance Academy Online Registration

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Welcome to THE INDUSTRY Dance Academy! Please complete the following registration form. In order to enroll in classes you will need to be placed in your proper level. Please email us when you have registered and to request your free trial. If you have any further questions our email is frontdesk@theindustrydanceacademy.com We look forward to meeting you. :)

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Referral Information

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City*

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Zip*

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Additional Info

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Contact #1

Contact #1 First Name*

Last Name *

Type*

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By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from THE INDUSTRY Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

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Contact #2

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Student #1

Student's First Name*

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Cell # By providing your phone number and checking this box, you agree to receive transactional and informational SMS messages from THE INDUSTRY Dance Academy. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out and HELP for help.

Additional Info

Student Email

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Primary Doctor

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Primary Doctor

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Birth Date*

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Primary Doctor

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Contact #1

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Student #1

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