Pro Dance Academy 2023-2024                                        Registration Form
6000 Meadowbrook Mall Ct., Suite 200 Clemmons
336.778.1121
prodanceacademync@yahoo.com
2023-2024 Dance Season
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Email *
Student's Name: *
Date of Birth/Age (as of Sept. 1) *
Parent's Name and Phone Number: *
Complete Address: *
How did you hear about us?: *
Emergency Contact (name/phone): *
Previous Dance Experience/Where: *
This student is enrolling for the following classes: *
Required
Enter specific day/time/teacher for the class(es) you selected: *
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