BDA Dancer Registration Form

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Email *

Student Name *

First and last name

Student's Date of Birth *

YYYY

Parent /Guardian Name *

Address

Phone Number *

List any Medical conditions, Allergies, or Unique needs/Medication

In the event of an emergency who should be contacted:

Emergency Contact Name and Number:

Person(s) authorized to pick up child
(Name and cell number): *

Acceptable payment methods - CASH, PayPal

Registration Fee: $50.00 Annually DUE UPON REGISTRATION (NON-REFUNDABLE)

Confirm Registration (Due in order to register) *

Yes, Register and pay - $50.00

No, Do not register

Monthly Class Fee: $160.00 MONTHLY
DUE ON THE 1st OF EACH MONTH (NON-REFUNDABLE)

Ballet, Tap, Jazz, Modern/Lyrical/Contemporary/Praise, & HipHop - DUE EVERY SATURDAY

Choose the Level *

1A/1B - Beginners

2A - Intermediate

3 - Advanced

Enter your Initials here for the Parent's Consent

Upon submission of this form, a BDA representative will promptly reach out to guide you through the initial steps and confirm your payment.

Submit

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