All That Jazz Online Registration

Registration

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Welcome to All That Jazz! Please complete the following registration form.

* denotes required fields

Referral Information

How did you hear about us?*

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Contact #1

Parent/Contact #1 First Name*

Last Name *

Relation*

How Can We Contact You?

Home Phone *

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Parent/Contact #2 First Name

Last Name

Relation

How can we contact you?

Home Phone

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Disabilities (Leave blank if NONE)

Special Needs and Restroom. Specify needs. Specify if restroom can/cannot be used independently.

Allergies (Leave blank if NONE)

Medications

Click on the "Select Class" button below, then choose the class. Be sure to check the dates and session you are selecting. You can filter sessions by using the magnifying glass at the top left of the page.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Disabilities (Leave blank if NONE)

Special Needs and Restroom. Specify needs. Specify if restroom can/cannot be used independently.

Allergies (Leave blank if NONE)

Medications

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Disabilities (Leave blank if NONE)

Special Needs and Restroom. Specify needs. Specify if restroom can/cannot be used independently.

Allergies (Leave blank if NONE)

Medications

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Disabilities (Leave blank if NONE)

Special Needs and Restroom. Specify needs. Specify if restroom can/cannot be used independently.

Allergies (Leave blank if NONE)

Medications

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Disabilities (Leave blank if NONE)

Special Needs and Restroom. Specify needs. Specify if restroom can/cannot be used independently.

Allergies (Leave blank if NONE)

Medications

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*

Jackrabbit Technologies' class management platform & registration portal is trusted by 1000s of
dance studios , gyms , swim schools , music schools , cheer gyms , childcare centers , and more .

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

(Show-Hide Details)