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Dance Dynamics 2021 - 2022 Registration Form

Please fill out one form per child!!

Students Name *

Age *

Date of Birth * +

Parent Names *

Street Address *

City *

State *

Zip Code *

Home Phone

Cell Phone

Work Phone

Best Contact Phone *

Home

Cell

Work

Email Address *

Emergency Contact *

Phone *

Class Choices * 🛈

Previous Dance Experience *

If eligible for an award at the 2022 recital , please indicate consecutive years attended at Dance Dynamics:

5yr

10yr

15yr

I give permission for my child’s photo to be used for social media purposes *

Yes

No

Please indicate if your child has any special needs:

Allergies:

Registration Fee *

$30

1 hour class

1 hour 15 minute class

1 hour 30 minute class

1 hour 45 minute class

2 hour class

2 hour 15 minute class

2 hour 30 minute class

Automatic recurring payments * 🛈

I agree to the terms of recurring payments.

Terms of Service * 🛈

I agree to the terms of service.

Privacy Policy * 🛈

I agree to the Privacy Policy

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