Registration
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Pickerington Dance Academy Student Registration

Parent/Guardian Data

PARENT First Name:

 Last Name:

Street Address:

City / State:

    

Zip Code:

E-mail Address:

Home Phone:

Session:

Comments/Referral:

 

Student Data

Student #1

Name:

 

Age:

 

Grade:

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Tiny Tot - Creative Movement:

Tumbling:

Lyrical:

Student #2

Name:

 

Age:

 

Grade:

 

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Tiny Tot - Creative Movement:

Tumbling:

Lyrical:

Student #3

Name:

 

Age:

 

Grade:

 

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Tiny Tot - Creative Movement:

Tumbling:

Lyrical:

Student #4

Name:

 

Age:

 

Grade:

 

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Tiny Tot - Creative Movement:

Tumbling:

Lyrical:

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Your 1st Monthly payment & Registration fee are due after you received a confirmation email. 

Check your Junk Folder if you don't receive the Confirmation email within 3 days.

 

e-mail Pickerington Dance Academy

Home | About the Studio | About the Director | Styles Offered | Schedule | Registration | Rules & Guidelines | News & Events