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Price range: $0.00 through $25.00

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Is this your first year with Upstage Dance Center?

Yes – this is our first year (Welcome!)

No – we participated in May 2026 (You’re on a roll!)

No – we took a break (Welcome back!)

Dancer’s Name (First)

Dancer’s Name (Last)

Dancer’s Date of Birth MM/DD/YYYY

Dancer’s Name of School

Dancer’s Grade in School

Please indicate any health concerns which may impact participation in dance class including allergies.

Emergency Contact Name

Emergency Contact Relationship to Student (parent, grandparent, spouse, etc.)

Emergency Contact Phone Number

Email of person to receive “Upstage News!” Emails

Name of the person financially responsible for dance lessons (to receive tuition reminders, invoices, etc.)

Email address for the person financially responsible for dance lessons (to receive tuition reminders, invoices, etc.)

Payment Option for Monthly Tuition

Pay Monthly via the Upstage Dance Center Website (due on the 10th of each month)

Pay with PayPal Monthly Auto Draft (recommended)

How did you hear about us?

SKU: N/A Category: Registration

Additional information

Start Here	1st Dancer, 2nd Dancer, 3rd Dancer, 4th Dancer

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