Dance Barre Online Registration

Registration

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REGISTRATION IS OPEN FOR OUR 2024-2025 DANCE SEASON!

* 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*

Province*

Postal Code*

Primary Phone*

Contact #1

Parent/Guardian #1 First Name*

Last Name *

Relationship to Dancer*

How Can We Contact You?

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Barre. Standard message and data rates apply. Reply STOP to opt out

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Parent/Guardian #2 First Name

Last Name

Relationship to Dancer

How can we contact you?

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Dance Barre. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if this doesn't apply to your dancer)

Allergies (Leave blank if this doesn't apply to your dancer)

Medications (Leave blank if this doesn't apply to your dancer)

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if this doesn't apply to your dancer)

Allergies (Leave blank if this doesn't apply to your dancer)

Medications (Leave blank if this doesn't apply to your dancer)

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if this doesn't apply to your dancer)

Allergies (Leave blank if this doesn't apply to your dancer)

Medications (Leave blank if this doesn't apply to your dancer)

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if this doesn't apply to your dancer)

Allergies (Leave blank if this doesn't apply to your dancer)

Medications (Leave blank if this doesn't apply to your dancer)

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Student Email

Special Needs (Leave blank if this doesn't apply to your dancer)

Allergies (Leave blank if this doesn't apply to your dancer)

Medications (Leave blank if this doesn't apply to your dancer)

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

Membership Type*

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

Country

City

Province

Postal Code

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Transit # (5-digits)

Institution ID (3-digits)

Account Number

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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

Account Information

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)