REGISTER_TEMPLATE

* Indicates required field

Student Name *

First

Last

Age *

Date of Birth *

Years Experience *

Previous Studios *

Monday

Tuesday

Wednesday

Thursday

Friday

Fri 4:30 - 5:30 *

None Next Step (NE) x

Fri 5:30 - 6:30 *

Option 1 Option 2 Option 3

Fri 6:30 - 7:30 *

Option 1 Option 2 Option 3

Saturday

Daytime - Weekdays

Tuesday 9:00 - 10:00 *

None Predance (HV)

Tuesday 10:00 - 11:00 *

None Tumbling Level 1 (HV)

Thursday 10:00 - 11:00 *

None Mommy and Me (HV)

Thursday 12:00 - 1:00 *

None Tumbling Level 1 (HV)

Mother's Name *

First

Last

Primary Email *

Primary Phone Number *

Primary Address *

Line 1

Line 2

City

State

Zip Code

Country

Please specify any special conditions or allergies. *

Father's Name *

First

Last

Secondary Email *

Secondary Phone Number *

Secondary Address *

Line 1

Line 2

City

State

Zip Code

Country

Medical Consent *

I Agree

Media Release *

I Agree

I approve of my child's participation in Vibe Performing Arts programs, and certify that he/she is in good health and able to participate in the program. If medical attention is required for illness or injury, I grant permission for such care to be rendered.

I authorize images and videos to be posted on websites,, promotional material, and social media that may be taken during events coordinated through Vibe Performing Arts.

Number of Classes *

Monthly Class Tuition *

"The Pulse" Company *

Honors Ballet *

Enrage Hip Hop Crew *

Total Monthly Tuition** *

Registration Fee* *

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Daytime - Weekdays

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