Dance Class Registration Form
Dance Class Registration Form
Please complete the registration form below to secure your spot.
Personal Information
Name
Gender
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Male
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Female
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Date of Birth
Address
Phone number
Dance Class Preference
Dance Style
Please select your preferred dance style(s):
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Ballet
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Hip Hop
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Jazz
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Modern
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Ballroom
Class Level
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Beginner
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Intermediate
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Advanced
Preferred Class Time
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Morning
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Afternoon
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Evening
Preferred Class Day(s)
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Monday
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Tuesday
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Wednesday
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Thursday
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Friday
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Saturday
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Sunday
How did you hear about us?
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Referral
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Social Media
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Website
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Flyer
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Event
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Advertisement
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Friend or Family
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Email Newsletter
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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:
