Dance Dayz Studio Online Registration

Registration

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Hi! Nadia here, and I am thrilled to welcome you to Dance Dayz Studio! We specialize in youth recreational dance classes and are SO excited to have your family join us for fitness, friendship, and fun.

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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*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Home Phone *

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

Student #1

Student's First Name*

Last Name*

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

Additional Info

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Classes are displayed for each age group. Petite is ages 3-5 years old, Mini is ages 5-7 years old, and Junior is aged 7-teen our Junior classes are broken into levels 1 and 2 based on availability.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

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

Additional Info

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Classes are displayed for each age group. Petite is ages 3-5 years old, Mini is ages 5-7 years old, and Junior is aged 7-teen our Junior classes are broken into levels 1 and 2 based on availability.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

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

Additional Info

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Classes are displayed for each age group. Petite is ages 3-5 years old, Mini is ages 5-7 years old, and Junior is aged 7-teen our Junior classes are broken into levels 1 and 2 based on availability.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

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

Additional Info

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Classes are displayed for each age group. Petite is ages 3-5 years old, Mini is ages 5-7 years old, and Junior is aged 7-teen our Junior classes are broken into levels 1 and 2 based on availability.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

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

Additional Info

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Classes are displayed for each age group. Petite is ages 3-5 years old, Mini is ages 5-7 years old, and Junior is aged 7-teen our Junior classes are broken into levels 1 and 2 based on availability.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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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)

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

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