Enrollment Application

Information provided will be used to determine and verify eligibility for program services and to ascertain the appropriateness of selected services.

Student information
Student's Full Name
Parent/Guardian's Name1
Parent/Guardian's Name 2
Age: Grade: School:
Home Address

City

State
Zip
Phone1
Phone2
Email

Are you a returning student?

Class of desired study:

  K-4 Creative Movement - 9 a.m.-10 a.m.    
  5-8 Contemporary Modern - 9 a.m.-10 a.m.     
  9-College Contemporary Modern - 10 a.m.-11 a.m.    


How did you find out about the Movement Makers Program?

Do you have any previous or current dance experience? If so, how many years? If no experience, please write N/A.

If so, at which level - beginner, intermediate, advanced? If no experience, please write N/A.

Movement Maker applicants must comply to the program requirements prior to receiving instruction.
Program Requirements. By clicking this checkbox I am agreeing to comply with the program's requirements. The program's requirements are:

1) A copy of the child's last report card
2) Parental attendance at the Orientation Meeting
3) Signed consent form, which includes an agreement to the attendance policy
4) A waiver of liability

For SPAM protection, you must type in the number 16 and submit your request: