Reach the Stars Class Registration 2022-2023

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Registration form for weekly classes at Reach the Stars dance

Email *

Please Read the following before Registering:

After you submit your registration form you will receive an emailed invoice (with in 48 hours of registering) to the email address you provide for the first month of classes. Your students spot in class is not guaranteed until first month has been paid in full.
If you do not receive the emailed invoice with in 48 hours - please contact us at 503-791-7110 or reachthestarsdance@yahoo.com

Student name: *

Parent/Guardian Name: *

Student Age *

Email address Class fee invoice should be sent to: *

Mailing address *

Phone number: *

Class(es) you are enrolling in: *

Does student Have any conditions or limitations that instructors should be aware of while participating in the class: *

yes

If yes, Please explain:

Pictures from classes and performances may be used for advertising or special promotions: *

I allow my students picture to be used

I DO NOT allow my students picture to be used

Have a coupon Code? Enter it here:

New Students: How did you hear about Reach the Stars Dance?

Policy agreement

By registering for Reach the Stars Dance and attending classes I agree to payment of class fees in a timely manner, That I have read and agree to all policies and fee information listed on the website and I will not hold Reach the Stars Dance or any entity working with Reach the Stars Dance in any location liable for damage, loss, or injury to any person or object.

I have read and agree to the above statement *

Yes

I understand that all pre-paid fees are non-refundable *

Yes

Required

A copy of your responses will be emailed to the address you provided.

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