Step 2 This Dance Studio Online Registration

Registration

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Welcome to Step 2 This Dance Studio! Welcome to our online registration. Please complete the following registration form.

* 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*

State*

Zip*

Home or 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

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 First Name

Last Name

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

Allergies (Leave blank if NONE)

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Registration Fee

$20 registration fee per year.

I've read the above and agree.

Injury Release:

I acknowledge that there is a risk of injury when receiving dance or acrobatic instruction. Understanding the activities to be conducted at or by Step 2 This Dance Studio, I release and forever discharge the Studio and its employees from any and all liability, claim, or loss arriving from an injury to me/my child and waive any such claims against the Studio and its employees.

I've read the above and agree.

Photos/Video Waiver

I understand and give permission for images of my child taken by Step 2 This Dance Studio’s owners or staff, via video or photography during activities conducted by/with Step 2 This Dance Studio, to be used solely for Step 2 This Dance Studio’s promotional material, publications and websites.

I've read the above and agree.

Studio Policy

Please read Step 2 This Dance Studio's School Policy and Rules.

I've read the above and agree.

Payment Policy

Payment methods:
1. Checks should be made payable to Step 2 This Dance Studio.
2. Zelle payments can be sent to (815) 739-3187
3. Chase Pay payments accepted to email address: kim@step2.dance
4. Pay via Credit Card below.

Tuition is non-refundable. $35 return check fee. If tuition is not paid 2 weeks into the session there will be a $25/month late fee.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

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