THE ROLLE PROJECT Online Registration

Registration

Already a customer? Click here to login.

Welcome to Studio 305! Home of the Rolle Project. We are excited to have you join our family. We are Real people, Real dancing, Creating stars! Please complete the following registration form below. If you have any questions after completing the forms call 702-444-0773 or 702-201-1197 to finalize your account Dress Code Studio 305 Black Leotard, Pink Tights for Ballet and & Pink soft ballet shoes & Studio T-shirt can be purchased in the office.

* 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 *

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*

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*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Immunization Notes

Dress Code Studio 305 Black Leotard, Pink Tights for Ballet and & Pink soft ballet shoes & Studio T-shirt can be purchased in the office.

Boys: Black studio 305 T-shirt and Black sweats or Shorts! Black Ballet shoes and Black Boys Leotard and Black Fitted Pants.

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*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Immunization Notes

Dress Code Studio 305 Black Leotard, Pink Tights for Ballet and & Pink soft ballet shoes & Studio T-shirt can be purchased in the office.

Boys: Black studio 305 T-shirt and Black sweats or Shorts! Black Ballet shoes and Black Boys Leotard and Black Fitted Pants.

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*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Immunization Notes

Dress Code Studio 305 Black Leotard, Pink Tights for Ballet and & Pink soft ballet shoes & Studio T-shirt can be purchased in the office.

Boys: Black studio 305 T-shirt and Black sweats or Shorts! Black Ballet shoes and Black Boys Leotard and Black Fitted Pants.

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*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Immunization Notes

Dress Code Studio 305 Black Leotard, Pink Tights for Ballet and & Pink soft ballet shoes & Studio T-shirt can be purchased in the office.

Boys: Black studio 305 T-shirt and Black sweats or Shorts! Black Ballet shoes and Black Boys Leotard and Black Fitted Pants.

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*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Immunization Notes

Dress Code Studio 305 Black Leotard, Pink Tights for Ballet and & Pink soft ballet shoes & Studio T-shirt can be purchased in the office.

Boys: Black studio 305 T-shirt and Black sweats or Shorts! Black Ballet shoes and Black Boys Leotard and Black Fitted Pants.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

e-Payment Schedule*

Membership Type

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*

Jackrabbit Technologies' class management platform & registration portal is trusted by 1000s of
dance studios , gyms , swim schools , music schools , cheer gyms , childcare centers , and more .

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)

Who is your employer?

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

Account Information

Credit Card

Required Policies

(Show-Hide Details)