Parent or Guardian Name(*)
Please enter the Parent or Guardian name.
Parent/Guardian Email Address(*)
Please enter a valid email address
Address(*)
Please enter your street address.
City(*)
Please enter your city.
State(*)
Please enter your state.
Zip Code(*)
Invalid Input
Home Phone (555-555-5555)(*)
Please enter your home phone.
Cell Phone
Invalid Input
Dancer 1 Name(*)
Please enter the name for Dancer 1
Dancer 1 Age(*)
Please enter the age for dancer 1
Dancer 1 Grade(*)
Enter the age of dancer 1.
Dancer 1 Years of Experience
Dancer 1: Type of classes desired this year (check all that apply)
Tap/Ballet (60 min) Tap/Ballet/Jazz/Hip-Hop (90 min) Hip-Hop (45 min) Classical Ballet (60 min) Other (Ballroom, Boys Class, Competitive Poms, Zumba, etc.) Invalid Input
Dancer 1 Preferred day of the week (check all that apply)
Monday Tuesday Wednesday Thursday Saturday Invalid Input
Dancer 1 Preferred Start Time (check all that apply)
9:15 AM (Tuesday & Wednesday) 10:15 AM (Tuesday & Wednesday) 1:00 PM (Tuesday & Wednesday) 4:30 PM (Monday through Thursday) 5:00 PM (Monday through Thursday) 6:00 PM (Monday through Thursday) 6:30 PM (Monday through Thursday) 8:00 AM (Saturday) 9:00 AM (Saturday) 10:00 AM (Saturday) 11:00 AM (Saturday) 12:00PM (Saturday) Invalid Input
Dancer 2 Name
Invalid Input
Dancer 2 Age
Invalid Input
Dancer 2 Grade
Enter the age of dancer 2.
Dancer 2 Years of Experience
Dancer 2: Type of classes desired this year (check all that apply)
Tap/Ballet (60 min) Tap/Ballet/Jazz/Hip-Hop (90 min) Hip-Hop (45 min) Classical Ballet (60 min) Other (Ballroom, Boys Class, Competitive Poms, Zumba, etc.) Invalid Input
Dancer 2 Preferred day of the week (check all that apply)
Monday Tuesday Wednesday Thursday Saturday Invalid Input
Dancer 2 Preferred Start Time (check all that apply)
9:15 AM (Tuesday & Wednesday) 10:15 AM (Tuesday & Wednesday) 1:00 PM (Tuesday & Wednesday) 4:30 PM (Monday through Thursday) 5:00 PM (Monday through Thursday) 6:00 PM (Monday through Thursday) 6:30 PM (Monday through Thursday) 8:00 AM (Saturday) 9:00 AM (Saturday) 10:00 AM (Saturday) 11:00 AM (Saturday) 12:00PM (Saturday) Invalid Input
Dancer 3 Name
Invalid Input
Dancer 3 Age
Invalid Input
Dancer 3 Grade
Enter the age of dancer 3.
Dancer 3 Years of Experience
Dancer 3: Type of classes desired this year (check all that apply)
Tap/Ballet (60 min) Tap/Ballet/Jazz/Hip-Hop (90 min) Hip-Hop (45 min) Classical Ballet (60 min) Other (Ballroom, Boys Class, Competitive Poms, Zumba, etc.) Invalid Input
Dancer 3 Preferred day of the week (check all that apply)
Monday Tuesday Wednesday Thursday Saturday Invalid Input
Dancer 3 Preferred Start Time (check all that apply)
9:15 AM (Tuesday & Wednesday) 10:15 AM (Tuesday & Wednesday) 1:00 PM (Tuesday & Wednesday) 4:30 PM (Monday through Thursday) 5:00 PM (Monday through Thursday) 6:00 PM (Monday through Thursday) 6:30 PM (Monday through Thursday) 8:00 AM (Saturday) 9:00 AM (Saturday) 10:00 AM (Saturday) 11:00 AM (Saturday) 12:00PM (Saturday) Invalid Input
Dancer 4 Name
Invalid Input
Dancer 4 Age
Invalid Input
Dancer 4 Grade
Enter the age of dancer 4.
Dancer 4 Years of Experience
Dancer 4: Type of classes desired this year (check all that apply)
Tap/Ballet (60 min) Tap/Ballet/Jazz/Hip-Hop (90 min) Hip-Hop (45 min) Classical Ballet (60 min) Other (Ballroom, Boys Class, Competitive Poms, Zumba, etc.) Invalid Input
Dancer 4 Preferred day of the week (check all that apply)
Monday Tuesday Wednesday Thursday Saturday Invalid Input
Dancer 4 Preferred Start Time (check all that apply)
9:15 AM (Tuesday & Wednesday) 10:15 AM (Tuesday & Wednesday) 1:00 PM (Tuesday & Wednesday) 4:30 PM (Monday through Thursday) 5:00 PM (Monday through Thursday) 6:00 PM (Monday through Thursday) 6:30 PM (Monday through Thursday) 8:00 AM (Saturday) 9:00 AM (Saturday) 10:00 AM (Saturday) 11:00 AM (Saturday) 12:00PM (Saturday) Invalid Input
Do any of your dancers have any health problems or allergies that we should be aware of? (yes or no)(*)
Yes No Invalid Input
If yes, explain
Invalid Input
Who Referred You?(*)
Invalid Input
Fall Class
Fee is $50.00 per student Invalid Input
Total number of registrants
1 2 3 4 Invalid Input
Total
Invalid Input