Latin Dance Canberra Pty Ltd Online Registration

Registration

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Welcome to Latin Dance Canberra!

Follow these 3 easy steps to book your spot in the classes.

Step 1 - Register your details and select the classes you are interested in.
Step 2 - Enter your payment details to submit your registration.
Step 3 - Once registered, you'll be redirected to our AWESOME student portal where you can view you class details, fees and process your payment.
(All submitted payments will be automatically processed nightly)

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Contact #1

Main Contact First Name*

Last Name *

How Can We Contact You?

Cell # *

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*

Student Gender*

Birth Date*

Cell #*

Additional Info

Student Email*

Once registered, you'll be redirected to our AWESOME student portal where you can view you class details, fees and process your payment.

(All submitted payments will be automatically processed nightly)

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*

Once registered, you'll be redirected to our AWESOME student portal where you can view you class details, fees and process your payment.

(All submitted payments will be automatically processed nightly)

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*

Once registered, you'll be redirected to our AWESOME student portal where you can view you class details, fees and process your payment.

(All submitted payments will be automatically processed nightly)

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*

Once registered, you'll be redirected to our AWESOME student portal where you can view you class details, fees and process your payment.

(All submitted payments will be automatically processed nightly)

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*

Once registered, you'll be redirected to our AWESOME student portal where you can view you class details, fees and process your payment.

(All submitted payments will be automatically processed nightly)

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

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

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

Payment Information

Credit Card

Required Policies

(Show-Hide Details)