Lessons by Lexe: Dance Studio Online Registration

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Welcome to Lessons by Lexe: Dance Studio! Please complete the following registration form. Payment is due the 1st of each month. Thank you!

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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*

Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

Type

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell #

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Put N/A if NONE)*

Special Needs (Put N/A if NONE)*

Allergies (Put N/A if NONE)*

Medications

Leotard Size

Dress Size

Pant Size

Please click on the Search button below, then choose the class. If you are unable to find the class you would like, please complete registration, leave a note, and we will message you directly.

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

T-Shirt Size*

School

Grade Level

Disabilities (Put N/A if NONE)*

Special Needs (Put N/A if NONE)*

Allergies (Put N/A if NONE)*

Medications

Leotard Size

Dress Size

Pant Size

Please click on the Search button below, then choose the class. If you are unable to find the class you would like, please complete registration, leave a note, and we will message you directly.

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

T-Shirt Size*

School

Grade Level

Disabilities (Put N/A if NONE)*

Special Needs (Put N/A if NONE)*

Allergies (Put N/A if NONE)*

Medications

Leotard Size

Dress Size

Pant Size

Please click on the Search button below, then choose the class. If you are unable to find the class you would like, please complete registration, leave a note, and we will message you directly.

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

T-Shirt Size*

School

Grade Level

Disabilities (Put N/A if NONE)*

Special Needs (Put N/A if NONE)*

Allergies (Put N/A if NONE)*

Medications

Leotard Size

Dress Size

Pant Size

Please click on the Search button below, then choose the class. If you are unable to find the class you would like, please complete registration, leave a note, and we will message you directly.

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

T-Shirt Size*

School

Grade Level

Disabilities (Put N/A if NONE)*

Special Needs (Put N/A if NONE)*

Allergies (Put N/A if NONE)*

Medications

Leotard Size

Dress Size

Pant Size

Please click on the Search button below, then choose the class. If you are unable to find the class you would like, please complete registration, leave a note, and we will message you directly.

Enroll in Classes

Select Class

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

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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)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

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Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

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Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

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Required Policies

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