Now Enrolling!

Fall registrations are accepted from July through the end of February. 

Winter registrations begin November 1st and are accepted thru the end of March.  

Summer registrations begin in April and are accepted thru the end of July.

We will gladly hold a spot in your child's class of choice, simply fill out the online registration form as completely as possible.  Our staff will get back to you with details on how to proceed.  Please note, your registration is not confirmed until deposit and completed medical form are on file.

 

Registration Form

	Student Name	Birthdate	Grade
1*
2
3
4

Parent Name*
Address*
Address Line 2
City*
State*
ZIP*
Home Phone #*
Cell Phone #
Email*
Confirm email*
How did you hear about us?

Class Info

Please provide a first and second choice for each class time and day.

Class Name	Student Name	Day	Time	Teacher

Emergency & Medical Information

Please list any medical conditions, learning disabilities, or developmental delays:

Student 1
Student 2
Student 3
Student 4

Emergency Contact
(Someone other than a parent)

Name*
Relationship*
Phone #*

Payment Options*

	Pay the entire season in full (Registration fee, Sept. — June Tuition) receive 5% discount when paid by cash or check only.
	Pay tuition by cash, check or credit card on or before the 10th of each month. After the 10th, subject to $20 late fee with NO EXCEPTIONS.
	On the 1st business day of each month we will automatically charge your MC/VS credit or debit card. Subject to $1.25 per class manual transaction fee.

Photo Release

	As the responsible party for the above mentioned student(s), I give Powell Dance Academy permission to place pictures of my student(s) on the Powell Dance Academy website, (www.powelldanceacademy.com), and to use in print advertising such as brochures and newspaper.
	I do not give Powell Dance Academy this permission

Anti-Spam Verification

Please type the third letter of the word "dance" in the box: