Dance Dynamics Studio Online Registration

Registration

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Registration is currently closed - please check back in May for our Summer Programs

* 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/Prov*

Postal Code*

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?

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

Type

How can we contact you?

Home Phone

Work #

Cell #

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

T-Shirt Size

School

Grade Level

Disabilities*

Special Needs*

Allergies*

Primary Doctor

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

School

Grade Level

Disabilities*

Special Needs*

Allergies*

Primary Doctor

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

School

Grade Level

Disabilities*

Special Needs*

Allergies*

Primary Doctor

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

School

Grade Level

Disabilities*

Special Needs*

Allergies*

Primary Doctor

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

T-Shirt Size

School

Grade Level

Disabilities*

Special Needs*

Allergies*

Primary Doctor

Add Another Student

Required Policies and Agreements

Studio Etiquette

As a studio member, I will respect the staff, dancers, other families of Dance Dynamics Studio, the facilities and all others when attending events outside the studio. I will not discuss other people's children. I will support the efforts of my dancer and her/his classmates. I understand there are progressions to learning and will respect the teacher's knowledge and ability to train my dancer in a safe and appropriate manner. In the event a concern or question arises I will arrange to meet with the teacher/studio director to discuss immediately.

I've read the above and agree.

Payment

Payments of Fees are due on or before the 1st class -
Credit Cards placed on file will automatically be processed for Registration fees & Costumes when applicable unless otherwise notified by email you will be paying by cash, cheque or e-transfer (security answer is to be dancedynamics ),

Debit cards are NOT accepted

Invalid Credit Cards will be assessed a $25 service fee - you have confirmed the information on file is correct

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

Country

City

State/Prov

Postal Code