Student Name *

First Name

Last Name

Student Birthdate *

MM

DD

YYYY

Gender *

Female

Male

For dance students, how do you want to pay for dance recital costumes?

We offer two options to pay for dance recital costumes: discounted at the time of registration or monthly installments. All costume fees paid are fully refundable if student withdraws prior to 12/1. (If costume is added after registration, additional charges may apply.)

Charge costumes at registration for a discount

Charge costumes on installments

We are not participating in the dance recital

We are not taking dance classes

Mobile Phone *

(###)

###

####

Home Phone

(###)

###

####

Text Opt Out: Please check here if you do not wish to receive updates via text messages regarding your registered classes and account

Do not text

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent 1 Name *

First Name

Last Name

Parent 1 Phone *

(###)

###

####

Parent 2 Name

First Name

Last Name

Parent 2 Phone

(###)

###

####

In completing this online form, by checking this box I agree to abide by the Performing Arts Academy of Jupiter policies located at http://www.performingartsacademyofjupiter.com/studio-policies/ *

I agree

Mobile Phone *

(###)

###

####

Home Phone

(###)

###

####

Text Opt Out: Please check here if you do not wish to receive updates via text messages regarding your registered classes and account

Do not text

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent 1 Name *

First Name

Last Name

Parent 1 Phone *

(###)

###

####

Parent 2 Name

First Name

Last Name

Parent 2 Phone

(###)

###

####

For dance students, how do you want to pay for dance recital costumes?

We offer two options to pay for dance recital costumes: discounted at the time of registration or monthly installments. All costume fees paid are fully refundable if student withdraws prior to 12/1. (If costume is added after registration, additional charges may apply.)

Charge costumes at registration for a discount

Charge costumes on installments

We are not participating in the dance recital

We are not taking dance classes

In completing this online form, by checking this box I agree to abide by the Performing Arts Academy of Jupiter policies located at http://www.performingartsacademyofjupiter.com/studio-policies/ *

I agree

Student 1 Name *

First Name

Last Name

Student 1 Birthdate *

MM

DD

YYYY

Student 1 Gender *

Female

Male

Student 2 Name *

First Name

Last Name

Student 2 Birthdate *

MM

DD

YYYY

Student 2 Gender *

Female

Male