Art In Motion Dance LLC Online Registration

Registration

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Welcome to Art In Motion Dance registartion web site for the Potomac Dance Club and Tiny City Academy Dance classes.

* denotes required fields

Referral Information

How did you hear about us?

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

Payee Name First Name*

Last Name *

How Can We Contact You?

Home Phone

Work #

Cell # *

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

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*

Additional Info

Special Needs (Leave blank if NONE)

What to Wear:

Comfort is key! Dancers can wear whatever they wore to school, as long as they can move freely. Athletic wear is ideal.
Footwear options include dance shoes (if they have them), sneakers, or socks.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

What to Wear:

Comfort is key! Dancers can wear whatever they wore to school, as long as they can move freely. Athletic wear is ideal.
Footwear options include dance shoes (if they have them), sneakers, or socks.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

What to Wear:

Comfort is key! Dancers can wear whatever they wore to school, as long as they can move freely. Athletic wear is ideal.
Footwear options include dance shoes (if they have them), sneakers, or socks.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

What to Wear:

Comfort is key! Dancers can wear whatever they wore to school, as long as they can move freely. Athletic wear is ideal.
Footwear options include dance shoes (if they have them), sneakers, or socks.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Special Needs (Leave blank if NONE)

What to Wear:

Comfort is key! Dancers can wear whatever they wore to school, as long as they can move freely. Athletic wear is ideal.
Footwear options include dance shoes (if they have them), sneakers, or socks.

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

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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

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies

(Show-Hide Details)