Free Dance Class Registration Form Template

Dance Class Registration Form

Please complete the registration form below to secure your spot.

Personal Information

Name

    Gender

      • Male

      • Female

      Date of Birth

        Address

          Phone number

            Email

              Dance Class Preference

              Dance Style

              Please select your preferred dance style(s):

                • Ballet

                • Hip Hop

                • Jazz

                • Modern

                • Ballroom

                Class Level

                  • Beginner

                  • Intermediate

                  • Advanced

                  Preferred Class Time

                    • Morning

                    • Afternoon

                    • Evening

                    Preferred Class Day(s)

                      • Monday

                      • Tuesday

                      • Wednesday

                      • Thursday

                      • Friday

                      • Saturday

                      • Sunday

                      How did you hear about us?

                        • Referral

                        • Social Media

                        • Website

                        • Flyer

                        • Event

                        • Advertisement

                        • Friend or Family

                        • Email Newsletter

                        Health and Emergency Information

                        Health Conditions

                        Please list any health conditions that we should be aware of.

                          Allergies (if any)

                          Please specify any allergies you have.

                            Emergency Contact Name

                              Relationship

                                Phone number

                                  Liability Waiver

                                  I acknowledge that I have read and understood the policies and procedures of the dance class. I agree to assume all risks associated with participation and release the dance studio from any liability for injury or damages.

                                  Name:

                                  Date:

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