TopFlight Dance Center Online Registration

Registration

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Welcome to TopFlight Dance Center! Please complete the following registration form.

* 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)*

Health Insurance Carrier

Contact #1

Contact #1 First Name*

Last Name *

Type*

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

Who is your employer?

Employer

Employer Phone

Employer Notes

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email

T-Shirt Size

School*

Grade Level

Transportation*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Skill Notes

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email

T-Shirt Size

School*

Grade Level

Transportation*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Skill Notes

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email

T-Shirt Size

School*

Grade Level

Transportation*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Skill Notes

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email

T-Shirt Size

School*

Grade Level

Transportation*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Skill Notes

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Cell #*

Additional Info

Student Email

T-Shirt Size

School*

Grade Level

Transportation*

Disabilities*

Special Needs*

Allergies*

Medications (Leave blank if NONE)

Primary Doctor

Immunization Notes

Skill Notes

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Studio Closing/Holidays/Weather

The studio will follow the Katy ISD school closings instructional calendar. When Katy ISD is closed due to weather or holiday closings the studio will be closed. As much as we would love to control the weather we can't and the studio will only provide make-up classes writhing your child's level due to inclimate weather closings. WE DO NOT PRO-RATE TUITION FOR STUDIO HOLIDAY CLOSINGS!