On Pointe Arts Online Registration

Registration

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Welcome to On Pointe Arts! Please provide your information below and click submit when complete. All enrollments are considered pending until we have reviewed your registration and posted any fees due. Applicable discounts will be applied as well. Once your enrollment has been processed, your account will automatically be charged and registration will be complete. Please email On Pointe Arts with any Questions or Concerns you have, prior to registering for class.

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name Last Name*

Where do you live?

Home Address*

City*

State*

Zip Code*

Primary Phone*

Additional Info

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

Health Insurance Carrier

Contact #1

Contact #1 (Primary) First Name*

Last Name *

Relationship

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*

Relationship*

How can we contact you?

Home Phone

Cell # * Receive Text Message Notifications

Email* (Emails are kept confidential)

Confirm Email*

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor

Student's Nickname

Student's Preferred Pronouns

Choose any filters to begin viewing available classes. Please contact the studio if you have trouble finding or enrolling in classes.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor

Student's Nickname

Student's Preferred Pronouns

Choose any filters to begin viewing available classes. Please contact the studio if you have trouble finding or enrolling in classes.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor

Student's Nickname

Student's Preferred Pronouns

Choose any filters to begin viewing available classes. Please contact the studio if you have trouble finding or enrolling in classes.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor

Student's Nickname

Student's Preferred Pronouns

Choose any filters to begin viewing available classes. Please contact the studio if you have trouble finding or enrolling in classes.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications

Additional Info

Student Email

T-Shirt Size

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Primary Doctor

Student's Nickname

Student's Preferred Pronouns

Choose any filters to begin viewing available classes. Please contact the studio if you have trouble finding or enrolling in classes.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Please fill out BANKING Payment Method

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 Code

eCheck/Bank Draft

Bank Name *

Account Type *

Your Account Name * (Your name on your bank statement)

Bank Routing Number * (9-digit number)

Account Number *

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

Required Policies

(Show-Hide Details)