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2022-2023 Registration Form
Performing Arts Academy of Virginia Beach
4402 Princess Anne Road, Suite 104
Virginia Beach, Virginia 23462
Visit us at
www.performingartsacademyvb.com
or
www.facebook.com/performingartsacademyofvirginiabeach
.
NEW FAMILIES: $25/child or $50/family NON-REFUNDABLE registration fee must accompany this form.
Please note you MUST fill out a separate registration form for each dancer!
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Email
*
Your email
Student's Name
*
Your answer
Date of Birth
*
Your answer
Child's Age and Grade
*
Your answer
Street Address including City, State, and Zip Code
*
Your answer
Parent/Legal Guardian's Name
*
Your answer
Parent/Legal Guardian's Contact Number
*
Your answer
Email
*
Your answer
Optional Second Email
If an additional family member needs communication from the studio, please list their email address here!
Your answer
Emergency Contact Name (besides parents/guardians)
*
Your answer
Emergency Contact Number
*
Your answer
Past Dance Experience
*
Your answer
Does your child have any dietary restrictions, allergies, or disabilities? If so, please indicate below. no
*
Your answer
How did you hear about us?
*
Your answer
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