Encore Performers Online Registration

Registration

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THANK YOU FOR REGISTERING FOR CLASSES AT ENCORE PERFORMERS! If you are a current student, please use the link above "Already a customer? Click here to login." Payment will be made separately following registration via email invoice. Please notify us at admin@encoreperformers.com if you do not receive it.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name*

FAMILY INFORMATION

FAMILY LAST Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Contact #1

PARENT #1 First Name*

Last Name *

Type

How Can We Contact You?

Home Phone *

Cell # * Receive Text Message Notifications

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

Type

How can we contact you?

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

PLEASE SELECT YOUR CLASS BELOW:

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

PLEASE SELECT YOUR CLASS BELOW:

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

PLEASE SELECT YOUR CLASS BELOW:

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

PLEASE SELECT YOUR CLASS BELOW:

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

T-Shirt Size

School

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

PLEASE SELECT YOUR CLASS BELOW:

Enroll in Classes

Select Class

Add Another Student