Pointe of Surrender Dance Studio Online Registration

Registration

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Welcome to Pointe of Surrender Dance Studio! We are so excited to help you/your dancer to "Find Your Surrender in Dance". We look forward to serving you! Registration is easy and convenient. Please complete registration below, select your class(es), and we will confirm your registration by posting tuition. Your registration is complete once fees have been paid. Please feel free to contact us with any questions at 314.778.3188 or info@pointeofsurrender.com

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Referral Information

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City*

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Primary Phone*

Contact #1

Contact #1 First Name*

Last Name *

Type*

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Home Phone

Work #

Cell # *

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Contact #2

Contact #2 First Name

Last Name

Type

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Work #

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Email (Emails are kept confidential)

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Student #1

Student's First Name*

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Additional Info

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School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

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Previous Studio*

Dance Experience*

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

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Previous Studio*

Dance Experience*

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*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Previous Studio*

Dance Experience*

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*

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School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Previous Studio*

Dance Experience*

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*

Additional Info

T-Shirt Size*

School*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Previous Studio*

Dance Experience*

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

Enroll in Classes

Select Class *

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Registration

Referral Information

Family Information

Where do you live?

Contact #1

How Can We Contact You?

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Contact #2

How can we contact you?

Student #1

Additional Info

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