Fall/Winter Program

Kids/Youth Dance Classes

Please fill out this form to begin registration!

Parent/Guardian's Name *

First

Last

Relationship to Student *

Email *

Please provide the best email address to contact you

Phone *

(###) ### ####

Student's Name *

First

Last

Student's Birthdate *

Student's Prior Dance Experience *

Style, Number of Years, Exam History, Previous Studio Name, etc.

Session(s) of Interest *

Please check any that apply

Dance Style(s) of Interest *

Additional Relevant Information

Policy *

By submitting this form, I give the Academy permission to store my information and respond to my inquiry. I understand I can request to have my data deleted at any time.

Yearly Registration Fee *

Price: $ 25.00

IMPORTANT! Touch submit to continue with the payment of the annual registration (only after the payment, your data will be registered)

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