The Dance Academy of Virginia Online Registration

Registration

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Welcome to THE DANCE ACADEMY OF VIRGINIA! Currently enrolled Families: You have a customer account. Login into the portal with your email & click "forgot password" if you didn't set a password yet. All new students complete form to register for classes. If you are interested in a NEW STUDENT PLACEMENT CLASS for $19 please select on form & add note in comments with student's dance background & interests. We'll contact you shortl

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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*

Contact #1

Parent First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

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

Additional Parent/Guardian First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

School

Grade Level*

Try 1st Class for $19 (Y/N)

22/23 School Year On-going Enrollment!

Classes Resume after Winter Break on January 3rd!!

Summer Camps Announced January 3rd!!

Contact the office for level placement guidance and an intro class assessment.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

School

Grade Level*

Try 1st Class for $19 (Y/N)

22/23 School Year On-going Enrollment!

Classes Resume after Winter Break on January 3rd!!

Summer Camps Announced January 3rd!!

Contact the office for level placement guidance and an intro class assessment.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

School

Grade Level*

Try 1st Class for $19 (Y/N)

22/23 School Year On-going Enrollment!

Classes Resume after Winter Break on January 3rd!!

Summer Camps Announced January 3rd!!

Contact the office for level placement guidance and an intro class assessment.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

School

Grade Level*

Try 1st Class for $19 (Y/N)

22/23 School Year On-going Enrollment!

Classes Resume after Winter Break on January 3rd!!

Summer Camps Announced January 3rd!!

Contact the office for level placement guidance and an intro class assessment.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

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

Cell # Receive Text Message Notifications

Additional Info

Student Email

School

Grade Level*

Try 1st Class for $19 (Y/N)

22/23 School Year On-going Enrollment!

Classes Resume after Winter Break on January 3rd!!

Summer Camps Announced January 3rd!!

Contact the office for level placement guidance and an intro class assessment.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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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

Family Information

Where do you live?

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

Required Policies

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