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Nielsen School of Dance 2022/2023 Registration Form
This is the official 2022- 2023 Dance registration form. If you have multiple children you can sign them up on one form. We will email you to confirm your registration. . If you have any questions please call or text 208-595-8188 or email
nielsenschoolofdance@gmail.com
.
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* Indicates required question
Child’s Full Name
*
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Age
*
Your answer
Dancer 1: Child's Grade for the 2022-2023 year
*
Your answer
Dancer 1: Child's T Shirt Size and shoe size
*
Your answer
Dancer 2: Child's Full Name
Your answer
Dancer 2: Child's Birthday
MM
/
DD
/
YYYY
Dancer 2: Child's Current Age
Your answer
Dancer 2: Child's Grade for the 2022-2023 year
Your answer
Dancer 2: Child's T Shirt Size and shoe size
Your answer
Dancer 3: Child's Full Name
Your answer
Dancer 3: Child's Birthday
MM
/
DD
/
YYYY
Dancer 3: Child's Current Age
Your answer
Dancer 3: Child's Grade for the 2022-2023 year
Your answer
Dancer 3: Child's T Shirt Size
Your answer
Mother's Full Name
*
Your answer
Mothers Employment
*
Your answer
Mothers Phone Number
*
Your answer
Father's Full Name
*
Your answer
Fathers Employment
*
Your answer
Fathers Phone Number
*
Your answer
Email Address
*
Your answer
Mailing Address
*
Your answer
Emergency Contact and Phone Number
*
Your answer
Which class are you interested in for the 2022-2023 year?
*
Monday 3:15-3:55 3 year old combo class
Tuesday’s 3:55-4:50: prek-K Dance experience
Tuesdays 4:15-5:10 K-1st combo
Tuesdays: 4:50-5:45: 3rd-4th grade combo class
Tuesdays 5:15-6:10 3rd-4th grade combo
Tuesdays 6:15-7:10: 5th-7th grade combo
Wednesdays 9:30-10:10: 3 Year old combo class
Wednesdays 3:50-4:45: 5/6 year old combo class
Wednesday 4:15-5:10: 4 year old combo (WAITLIST)
Wednesday 5:15-6:10: 1st-2nd grade combo
Required
Please list any special conditions, medications, allergies we should know about
*
Your answer
Where did you hear about Nielsens?
*
Your answer
List any dance experience you’ve had
*
Your answer
Are you interested in trying out for our competition dance teams? (Need to have 2 years of dance experience)
Yes
No
Clear selection
Any other questions or comments?
Your answer
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