Student Registration

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Home
Fall and Spring Schedule
Registration
Reviews
Payments
Media and Events
Store
Donate
Contact Us
Schedule Auditions

Registration

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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Home
Fall and Spring Schedule
Registration
Reviews
Payments
Media and Events
Store
Donate
Contact Us
Schedule Auditions