Kinesics Dance Dynamics Online Registration

Registration

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Welcome to Kinesics Dance Dynamics!

* denotes required fields

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)*

Person responsible for tuition*

Contact #1

Contact #1 First Name*

Last Name *

Type*

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

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Persons allowed to drop off/pick up your child*

Disabilities (If none, please indicate "n/a")*

Relevant medical history that may impact you/your child's ability to dance (If none, please indicate*

Allergies (If none, please indicate "n/a")*

Medications (If none, please indicate "n/a")*

Previous Dance Training*

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

Prerequisites:

*Beginner II/III & Intermediate/Advanced Level Classes - Students must receive permission from KDD staff to enroll in any Beginner II/III & Intermediate/Advanced Classes.

*Jazz Classes (all levels) - students wishing to enroll in Jazz must also be enrolled in a Ballet class.

Not sure which classes to enroll in? No problem! Feel free to email us (kdd@kinesicsdance.com) and we will assist you with the process.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Persons allowed to drop off/pick up your child*

Disabilities (If none, please indicate "n/a")*

Relevant medical history that may impact you/your child's ability to dance (If none, please indicate*

Allergies (If none, please indicate "n/a")*

Medications (If none, please indicate "n/a")*

Previous Dance Training*

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

Prerequisites:

*Beginner II/III & Intermediate/Advanced Level Classes - Students must receive permission from KDD staff to enroll in any Beginner II/III & Intermediate/Advanced Classes.

*Jazz Classes (all levels) - students wishing to enroll in Jazz must also be enrolled in a Ballet class.

Not sure which classes to enroll in? No problem! Feel free to email us (kdd@kinesicsdance.com) and we will assist you with the process.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Persons allowed to drop off/pick up your child*

Disabilities (If none, please indicate "n/a")*

Relevant medical history that may impact you/your child's ability to dance (If none, please indicate*

Allergies (If none, please indicate "n/a")*

Medications (If none, please indicate "n/a")*

Previous Dance Training*

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

Prerequisites:

*Beginner II/III & Intermediate/Advanced Level Classes - Students must receive permission from KDD staff to enroll in any Beginner II/III & Intermediate/Advanced Classes.

*Jazz Classes (all levels) - students wishing to enroll in Jazz must also be enrolled in a Ballet class.

Not sure which classes to enroll in? No problem! Feel free to email us (kdd@kinesicsdance.com) and we will assist you with the process.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Persons allowed to drop off/pick up your child*

Disabilities (If none, please indicate "n/a")*

Relevant medical history that may impact you/your child's ability to dance (If none, please indicate*

Allergies (If none, please indicate "n/a")*

Medications (If none, please indicate "n/a")*

Previous Dance Training*

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

Prerequisites:

*Beginner II/III & Intermediate/Advanced Level Classes - Students must receive permission from KDD staff to enroll in any Beginner II/III & Intermediate/Advanced Classes.

*Jazz Classes (all levels) - students wishing to enroll in Jazz must also be enrolled in a Ballet class.

Not sure which classes to enroll in? No problem! Feel free to email us (kdd@kinesicsdance.com) and we will assist you with the process.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size*

Persons allowed to drop off/pick up your child*

Disabilities (If none, please indicate "n/a")*

Relevant medical history that may impact you/your child's ability to dance (If none, please indicate*

Allergies (If none, please indicate "n/a")*

Medications (If none, please indicate "n/a")*

Previous Dance Training*

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

Prerequisites:

*Beginner II/III & Intermediate/Advanced Level Classes - Students must receive permission from KDD staff to enroll in any Beginner II/III & Intermediate/Advanced Classes.

*Jazz Classes (all levels) - students wishing to enroll in Jazz must also be enrolled in a Ballet class.

Not sure which classes to enroll in? No problem! Feel free to email us (kdd@kinesicsdance.com) and we will assist you with the process.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Membership Type*

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

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

eCheck/Bank Draft

Required Policies

(Show-Hide Details)