J'Danse Studio Online Registration

Registration

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WELCOME to J'DANSE STUDIO! In order to register, please fill out all required fields of the registration form below, including payment information. Once this information has been filled in you may "Select Class" to enroll. You will receive a confirmation email once your registration has been submitted. You will be re directed to our Welcome Package link for more details after your registration. Once your registration has been approved your payment will be processed accordingly.

* 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*

Prov*

Postal Code*

Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)*

Emergency Contact Relationship

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

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

Disabilities (Leave blank if NONE)

Injuries/Surgeries?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class(es):

Welcome Package: https://www.jdansestudio.com/welcome-package.html

Class Schedule: https://www.jdansestudio.com/class-schedule.html

Dress Code: https://www.jdansestudio.com/dress-code.html

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

Disabilities (Leave blank if NONE)

Injuries/Surgeries?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class(es):

Welcome Package: https://www.jdansestudio.com/welcome-package.html

Class Schedule: https://www.jdansestudio.com/class-schedule.html

Dress Code: https://www.jdansestudio.com/dress-code.html

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

Disabilities (Leave blank if NONE)

Injuries/Surgeries?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class(es):

Welcome Package: https://www.jdansestudio.com/welcome-package.html

Class Schedule: https://www.jdansestudio.com/class-schedule.html

Dress Code: https://www.jdansestudio.com/dress-code.html

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

Disabilities (Leave blank if NONE)

Injuries/Surgeries?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class(es):

Welcome Package: https://www.jdansestudio.com/welcome-package.html

Class Schedule: https://www.jdansestudio.com/class-schedule.html

Dress Code: https://www.jdansestudio.com/dress-code.html

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

Disabilities (Leave blank if NONE)

Injuries/Surgeries?

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please click on the Search button below, then choose the class(es):

Welcome Package: https://www.jdansestudio.com/welcome-package.html

Class Schedule: https://www.jdansestudio.com/class-schedule.html

Dress Code: https://www.jdansestudio.com/dress-code.html

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

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

Prov*

Postal Code*

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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

Account Information

Credit Card

Required Policies

(Show-Hide Details)