Register - Soaring Dance Theatre

Student's Information

Student's Name

First Last

Is Student Under 18 years of age?*

Yes, Under 18
No, Over 18

Student's Age As of Today

Address

Street Address City State ZIP Code

Student Email, if over 18

Student's Phone, if over 18

Parent's Information

Parent's Name (if student is under 18)

First Last

Parent Email*

Parent's Cell Phone

Parent's Other Phone

Our Classes

All students must be registered in person, at the Studio. Call 845-781-6099 for an appointment.

Select Class/ Classes

NOTE:
Dance Track I includes Dance Expression Class + Ballet Technique and Pointe
Dance Track II includes Dance Expression Class + Ballet Technique and Pointe + Company Class

Once classes or series of lessons have started tuitions are non-refundable. There is no additional registration fee.

Health/Emergency Contacts

Any Health Issues? (asthma, diabetes, weak knees, heart problems, lower back issues, etc)

Emergency Contact #1*

First Last

Emergency Phone #1*

Emergency Phone #2*

Consent*

I have read and accept the conditions of the above information. I understand I will pay by Class Fee in person at the Studio.

Consent*

Dance and theatre classes are physical pursuits, I understand that Soaring Dance Theatre will not be held responsible for any injuries incurred in these classes.

Signed by: Full Name Here

Today's Date

Name

This field is for validation purposes and should be left unchanged.

Student's Information

Parent's Information

Our Classes

Health/Emergency Contacts

Soaring Dance Theatre

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