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Home
Fall and Spring Schedule
Registration
Reviews
Payments
Media and Events
Store
Support Us
Mission Statement
Contact Us
Student Registration Form
Student Information
*
Indicates required field
Student Name
*
First
Last
Students Age
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Home Number
*
Cell Number
*
Email (For Confirmation/Reminders)
*
How did you hear about the Program
*
Friend
Internet
Other
If Other, please explain
*
What Session are you signing up for?
*
Creative Dance
Voice
Pre-Ballet
Pre-Ballet & Tap
Beginning Ballet
Beginning Ballet & Tap
Ballet Level II & Tap
Ballet Level III
Hip Hop
Musical Theater 15 Week Intensive
Age requirements For Each Class
Creative Dance
(ages 3-5)
Voice
(age 5-up)
Pre-Ballet
(ages 6-8)
Ballet
(ages 8-up)
Tap
(ages 6-up)
Hip Hop
(ages 6-up)
Musical Theater 15 week intensive on Saturday from 11-3pm
We offer Package 1 and Package 2
Acting
Voice
Dance (Tap & Ballet and Theater)
Sketch
Contact Information
Parents/Guardian Name
*
First
Last
Home Number
*
Work/Cell Number
*
Emergency Contact Name
*
First
Last
Relationship to Student
*
Emergency Number
*
Alternate Number
*
Medical Information
Does your child have a life-threatening health condition? (See note below)
*
YES
NO
If Yes, please explain
*
Does your child need medication?
*
Yes
No
If Yes, please explain
*
Does your child have any other medical issues of which we need to be aware?
*
Yes
No
Note:Parents/Guardian are responsible for all medication during Meet Ups. VPAC program staff will not be responsible for carrying or administrating any medication. (prescribed, over the counter, including aspirins and/or cough medicine.
Note: Payment Policy
*
I understand the payment policies as indicated. I agree to make payment for the full tuition.
I agree to receiving marketing and promotional materials
Submit
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Fall and Spring Schedule
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Store
Support Us
Mission Statement
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