Registration
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Welcome to Legacy Dance Studio!
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Referral Information
How did you hear about us?
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Coupon
Facebook
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Internet Search
Other
Parent Magazine
Performance
Referral
Returning Family
Walk-in
Website
Word of mouth
Referral Name
Family Information
Family Last Name
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Where do you live?
Home Address
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City
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State
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AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
PR
VI
Zip
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Primary Phone
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Additional Info
Emergency Contact Info (Not Contact #1 or #2)
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Contact #1
Contact #1 First Name
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Last Name
*
Type
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Caregiver
Father
Grandmother
Guardian
Mother
Parent
Self
How Can We Contact You?
Home Phone
Work #
Cell #
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Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Portal Access (your email is your login)
Email
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(Emails are kept confidential)
Confirm Email
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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
Caregiver
Father
Grandmother
Guardian
Mother
Parent
Self
How can we contact you?
Home Phone
Work #
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Email
(Emails are kept confidential)
Confirm Email
Student #1
Student's First Name
*
Last Name
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Birth Date
*
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Additional Info
Student Email
T-Shirt Size
*
Adult Large
Adult Medium
Adult Small
Adult X-Large
Child Large
Child Medium
Child Small
Child X-Large
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #2
(Show-Hide Details)
Student's First Name
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Last Name
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Birth Date
*
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Additional Info
Student Email
T-Shirt Size
*
Adult Large
Adult Medium
Adult Small
Adult X-Large
Child Large
Child Medium
Child Small
Child X-Large
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #3
(Show-Hide Details)
Student's First Name
*
Last Name
*
Birth Date
*
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Additional Info
Student Email
T-Shirt Size
*
Adult Large
Adult Medium
Adult Small
Adult X-Large
Child Large
Child Medium
Child Small
Child X-Large
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #4
(Show-Hide Details)
Student's First Name
*
Last Name
*
Birth Date
*
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Additional Info
Student Email
T-Shirt Size
*
Adult Large
Adult Medium
Adult Small
Adult X-Large
Child Large
Child Medium
Child Small
Child X-Large
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Student #5
(Show-Hide Details)
Student's First Name
*
Last Name
*
Birth Date
*
Cell #
Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Legacy Dance Studio. Standard message and data rates apply. Reply STOP to opt out
Additional Info
Student Email
T-Shirt Size
*
Adult Large
Adult Medium
Adult Small
Adult X-Large
Child Large
Child Medium
Child Small
Child X-Large
Child X-Small
School
Grade Level
10th grade
11th grade
12th grade
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
Adult
college
college-freshman
college-junior
college-senior
college-sophomore
kindergarten
pre-K
preschool
Disabilities (Leave blank if NONE)
Special Needs (Leave blank if NONE)
Allergies (Leave blank if NONE)
Medications (Leave blank if NONE)
Add Another Student
Required Policies
(Show-Hide Details)
I Agree to All of the Above
Enter your Full Name
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May 23, 2025
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Annual
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