Platinum Performing Arts Online Registration

Registration

Already a customer? Click here to login.

Complete the following registration form to setup your Portal with Platinum Performing Arts. In the Portal, you'll be able to enroll and pay for any of our classes. (New students can select "Trial" to try one class for free without enrolling!) When you enroll in your first class, the $40 annual registration fee will be added to your account. A dress code approved leotard or T-Shirt is included in the registration fee.

* denotes required fields

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info

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

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

Student #1

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Special Needs/Accommodations Needed (Leave blank if NONE)

Allergies (Leave blank if NONE)

Would you like to schedule an Inclusion Program or All Abilities services meeting? (Type yes or no)

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

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Special Needs/Accommodations Needed (Leave blank if NONE)

Allergies (Leave blank if NONE)

Would you like to schedule an Inclusion Program or All Abilities services meeting? (Type yes or no)

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

Special Needs/Accommodations Needed (Leave blank if NONE)

Allergies (Leave blank if NONE)

Would you like to schedule an Inclusion Program or All Abilities services meeting? (Type yes or no)

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*

Last Name*

Student Gender

Birth Date*

Additional Info

T-Shirt Size

Special Needs/Accommodations Needed (Leave blank if NONE)

Allergies (Leave blank if NONE)

Would you like to schedule an Inclusion Program or All Abilities services meeting? (Type yes or no)

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

Special Needs/Accommodations Needed (Leave blank if NONE)

Allergies (Leave blank if NONE)

Would you like to schedule an Inclusion Program or All Abilities services meeting? (Type yes or no)

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

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

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Registration

Family Information

Where do you live?

Additional Info

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

Required Policies

(Show-Hide Details)