Star 2B Performing Arts Online Registration

Registration

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Spring 2020 Registration is Now Open!

* 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?

Work #

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email*

T-Shirt Size

Disabilities*

Special Needs*

Allergies*

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

Disabilities*

Special Needs*

Allergies*

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

Disabilities*

Special Needs*

Allergies*

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

Disabilities*

Special Needs*

Allergies*

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

Disabilities*

Special Needs*

Allergies*

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Hold Harmless

By submitting this online waiver, you release Pink Beehive Productions/Star To Be Performing Arts and its affiliates and employees from all claims related to any injury which may be sustained by you or your child while attending any of our classes, or events associated with Pink Beehive Productions/Star To Be Performing Arts. You also affirm that you currently have and will continue to carry proper medical, health, hospitalization, and accident insurance, which you consider adequate for you or your child.

I've read the above and agree.

Photo Waiver

We would like your permission to use your child's photo in our advertising. Including but not limited to social media, print media, possible TV

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number