The Vibe Dance Center Online Registration

Registration

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Welcome to The Vibe Dance Center! We're excited for you tor join our #vibetribe! 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*

Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

Parent/Guardian*

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

Parent/Guardian

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*

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Select the class that BEST suites your schedule based on your dancer's age. If you do not find a class time that works for you or if you aren't sure which class to select, please email thevibedance@gmail.com

Please note the studio LOCATION when selecting a class. MAIN is our Milledgeville location and EATSTU is our Eatonton location.

Payment is required to secure enrollment. Registration fee of $30 for returning students and $35 for new students will be charged once registration is received.

All Payment methods can be entered by logging into your Parent Portal from our website.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please note the studio LOCATION when selecting a class. MAIN is our Milledgeville location and EATSTU is our Eatonton location.

Payment is required to secure enrollment. Registration fee of $30 for returning students and $35 for new students will be charged once registration is received.

All Payment methods can be entered by logging into your Parent Portal from our website.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please note the studio LOCATION when selecting a class. MAIN is our Milledgeville location and EATSTU is our Eatonton location.

Payment is required to secure enrollment. Registration fee of $30 for returning students and $35 for new students will be charged once registration is received.

All Payment methods can be entered by logging into your Parent Portal from our website.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please note the studio LOCATION when selecting a class. MAIN is our Milledgeville location and EATSTU is our Eatonton location.

Payment is required to secure enrollment. Registration fee of $30 for returning students and $35 for new students will be charged once registration is received.

All Payment methods can be entered by logging into your Parent Portal from our website.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

School

Grade Level

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please note the studio LOCATION when selecting a class. MAIN is our Milledgeville location and EATSTU is our Eatonton location.

Payment is required to secure enrollment. Registration fee of $30 for returning students and $35 for new students will be charged once registration is received.

All Payment methods can be entered by logging into your Parent Portal from our website.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

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*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

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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

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)