Registration
                                                                
                                                    

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 #1

Name:

 

Age:

 

Grade:

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Pointe:

Tumbling:

Lyrical:

Student #2

Name:

 

Age:

 

Grade:

 

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Pointe:

Tumbling:

Lyrical:

Student #3

Name:

 

Age:

 

Grade:

 

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Pointe::

Tumbling:

Lyrical:

Student #4

Name:

 

Age:

 

Grade:

 

Interests (Select Class Times that Apply)

Ballet:

Jazz:

Preschool Combo:

Hip-Hop:

Tap:

Pointe::

Tumbling:

Lyrical:

Back to Top

 Include your Registration fee with your 1st Monthly payment.

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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

e-mail Pickerington Dance Academy

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