ETD DANCE STUDIO Online Registration

Registration

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SUMMER CLASSES ARE OPEN! 1. Complete the Online Reg. Form Below. 2.Press Submit 3. You will be re-directed to the " ETD Parent Portal" 4. Log in to see your "Posted Fees" for the class(es) you just registered for. 5. CLICK PAY NOW to Make PAYMENT *YOUR CHILD IS NOT REGISTERED FOR CLASS NOR THEIR SPOT HELD UNTIL ALL FEES ARE PAID 6. Once payment has been successfully processed you will receive a Welcome Letter from us. Let's DANCE!!! ETD Dance Studio

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Referral Information

How did you hear about us?*

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)*

Virtual (Y or N)*

Contact #1

Contact #1: Parent 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 : Parent First Name

Last Name

Type

How can we contact you?

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Cell #

Additional Info

Student Email (enter if student has an email address))

T-Shirt Size

School*

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

In Person (Y or N)*

Virtual (Y or N)*

*Note: To purchase class leotards and shoes, please contact the studio front desk at (770)870-0684 or complete to request a personalized fitting.

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

Student Email (enter if student has an email address))

T-Shirt Size

School*

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

In Person (Y or N)*

Virtual (Y or N)*

*Note: To purchase class leotards and shoes, please contact the studio front desk at (770)870-0684 or complete to request a personalized fitting.

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

Student Email (enter if student has an email address))

T-Shirt Size

School*

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

In Person (Y or N)*

Virtual (Y or N)*

*Note: To purchase class leotards and shoes, please contact the studio front desk at (770)870-0684 or complete to request a personalized fitting.

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

Student Email (enter if student has an email address))

T-Shirt Size

School*

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

In Person (Y or N)*

Virtual (Y or N)*

*Note: To purchase class leotards and shoes, please contact the studio front desk at (770)870-0684 or complete to request a personalized fitting.

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

Student Email (enter if student has an email address))

T-Shirt Size

School*

Grade Level

Transportation

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies*

Medications*

In Person (Y or N)*

Virtual (Y or N)*

*Note: To purchase class leotards and shoes, please contact the studio front desk at (770)870-0684 or complete to request a personalized fitting.

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*

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Registration

Referral Information

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)