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REGISTRATION
FORM
Dee Dots Dance Handbook
DDDA Registration
Please note there is a $25 registration processing fee in addition to the registration fee.
Student Name(s)
(Required)
D. O. B
MM slash DD slash YYYY
Mom’s Email
(Required)
Dad’s Email
(Required)
Address
Street Address
City
State
Zip Code
Mom Cell Phone
Dad Cell Phone
Emergency Contact
(Required)
Emergency Phone
(Required)
Email
(Required)
Allergies or Medical
Class Choice
GoJu Karate/Tumbling (Boys and Girls 3-4 yr)
Rhythmettes (Ballet and Creative Dance) (Boys & Girls 3 yr)
Irish Beginner Class (All Ages)
Mini Troupe (Ballet, Tap, Jazz) (7-10yr)
Contemporary (10 & up)
Jr. Troupe (Ballet, Jazz & Tap) (10-13 yr)
Fairytales (Boys & Girls Age 2)
Mommy and Me / Daddy and Me (Parent Participation Required) (12-24mo)
Tiny Twirl and Tumble (Parents Participation Required) (2-3 yr)
Fancy Feet (Ballet and Tap) (Boys & Girls 4 yr)
Acro-Tubmling (Boys & Girls 3-4 yr)
Acro / Jazz (6-9 years)
Acro / Jazz (Boys and Girls 10 years and up)
Ninja Acro Course (Boys & Girls 3-4 yr)
Baton (Boys & Girls All Ages)
Pointe (ability/level)
Hip Hop (7 - 10 yr)
Elite Hip Hop (11 yr and up)
Sr. Troupe Ballet (Ability/Level)
Sr .Troupe Jazz and Tap (Ability/Level)
Adult Pilates
Adult Jazz
Adult Tap
Mini Competition Team (Ability/Level)
Senior Competition Team (Ability/Level)
Showstoppers - Ballet and Tap (5-6 year olds)
Hip Hop 5-6 yr
Tap 5-7 yr
Summer Class
Fancy Feet (Ballet/Jazz/Tap) Ages 3-5
Ballet/jazz/tap Ages 6-9
Ballet/lyrical Ages 10 and up
Tap/Jazz Ages 10 and up
GoJu Karate/Tumbling (Boys and Girls 3-4 yr)
(Required)
Monday 12:30 pm - 1:15 pm
Tuesday 12:30 pm - 1:15 pm
Rhythmettes (Ballet and Creative Dance) (Boys & Girls 3-4 yr)
(Required)
Tuesday 12:30 pm - 1:15 pm
Hip Hop (5 & 6 years of age)
(Required)
Monday 4:45 - 5:15pm
Rhythmettes (Ballet and Creative Dance) (Boys & Girls 3 yr)
(Required)
Tuesday 12:30 pm - 1:15 pm
Wednesday 11:45 pm - 12:30 pm
Irish Beginner Class (All Ages)
(Required)
Wednesday 6:30 pm - 7:15 pm
Mini Troupe (Ballet, Tap, Jazz) (7-10yr)
(Required)
Wednesday 5:00 pm - 6:30 pm
Contemporary (10 & up)
(Required)
Monday 7:30 pm - 8:30 pm
Jr. Troupe (Ballet, Jazz & Tap) (10-13 yr)
(Required)
Wednesday 8:00pm - 9:00pm
Fairytales (Boys & Girls Age 2)
(Required)
Monday 11:30 am - 12:15 pm
Tuesday 11:30 am - 12:15 pm
Tuesday 5:30 am - 6:15 pm
Fancy Feet (Ballet and Tap) (Boys & Girls 4 yr)
(Required)
Wednesday 12:30 pm - 1:15 pm
Wednesday 5:30 pm - 6:15 pm
Thursday 1:15 pm - 2:00 pm
Thursday 5:00 - 5:45 pm
Acro-Tubmling (Boys & Girls 3-4 yr)
(Required)
Monday 12:30 pm - 1:15 pm
Tuesday 1:15 pm - 2:00 pm
Acro / Jazz (6-9 years)
(Required)
Monday 6:30 pm - 7:30 pm
Acro / Jazz (Boys and Girls 10 years and up)
(Required)
Tuesday 5:30 pm - 6:30 pm
Ninja Acro Course (Boys & Girls 3-4 yr)
(Required)
Thursday 12:30 pm - 1:15 pm
Baton (Boys & Girls All Ages)
(Required)
Tuesday 6:30 pm - 7:15 pm
Hip Hop (7 - 10 yr)
(Required)
Wednesday 6:30 pm - 7:15 pm
Elite Hip Hop (11 yr and up)
(Required)
Wednesday 7:15pm - 8:00pm
Sr .Troupe Jazz and Tap (Ability/Level)
(Required)
Tuesday 8:15 pm - 9:00 pm
Sr. Troupe Ballet (Ability/Level)
(Required)
Tuesday 7:15 pm - 8:15 pm
Adult Tap
(Required)
Thursday 8:15 pm - 8:45 pm
Adult Jazz
(Required)
Thursday 7:45 pm - 8:15 pm
Mini Competition Team (Ability/Level)
(Required)
Thursday 6:00 pm - 6:45 pm
Senior Competition Team (Ability/Level)
(Required)
Thursday 6:45 pm - 7:45 pm
Showstoppers - Ballet and Tap (5-6 year olds)
(Required)
Monday 5:15 pm - 6:15 pm
Fancy Feet (Ballet/Jazz/Tap) Ages 3-5
(Required)
Tuesday 4:45PM - 5:30PM
Ballet/jazz/tap Ages 6-9
(Required)
Tuesday 5:30PM - 6:30PM
Ballet/lyrical Ages 10 and up
(Required)
Tuesday 6:30PM - 7:30PM
Tap/Jazz Ages 10 and up
(Required)
Tuesday 7:30PM - 8:30PM
Tiny Twirl and Tumble (Parents Participation Required) (2-3 yr)
(Required)
Thursday 4:30 pm- 5:15 pm
Pointe (ability/level)
(Required)
Tuesday 6:30pm - 7:15pm
Tap 5-7 yr
(Required)
Thursday 5:45pm - 6:30pm
Creation Academy Student
Yes
No
The undersigned parent/student indemnifies and agrees to holds harmless Dee Dots Dance Academy (DDCA), its Board of Directors, officers, instructors, agents, and assigns from any and all liability whatsoever, for any damage or injuries, and from any and all claims and demands, including attorney fees, arising out of the party’s participation in dance lessons, classes, workshops, performances, karate, fundraisers and other related activities provided by and/or at the facility of DDCA. The undersigned parent/student understands that students may occasionally appear in promotional performance videos, photos, brochures, and other materials as a result of his/her association with DDCA. By registering a child/student for class, such use of the child/student’s name and likeness are agreed to and acknowledged and, accordingly, all right, title and interest in same are waived.
Consent
(Required)
I have read and agree to the above terms and conditions of this agreement
(Required)
Consent
(Required)
I have read Dee Dots Dance Academy
Handbook
.
(Required)
Date
MM slash DD slash YYYY
Printed Name
Signature
(Parent's signature if student is under 18)
2591
26248