Showcase Dance Productions Online Registration

Registration

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Welcome to Showcase Dance Productions

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)

Contact #1

Contact #1 First Name*

Last Name *

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

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please refer to our website for class dress code and shoe requirement.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please refer to our website for class dress code and shoe requirement.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please refer to our website for class dress code and shoe requirement.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please refer to our website for class dress code and shoe requirement.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

Grade Level*

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Please refer to our website for class dress code and shoe requirement.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Release of Liability

Showcase Dance Productions, and the instructors, are not liable for personal injuries or loss of personal property. Each student may decline to participate in any activity, which may be harmful due to any physical limitations the student may have. Injuries may occur since this is a physical activity. If a student should withdraw from class, refunds will not be given on costumes.

Photos of my child's class may be used for advertising purposed only (Web site / brochures / Facebook / Instagram). If you do not approve this, please notify our studio by sending an email to showcasedanceproductions@yahoo.com

I've read the above and agree.

Payment Policies

A NON-REFUNDABLE Registration Fee of $35.00 per student or $60.00 per family, will be added to your first Tuition Payment

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments