Form Page: Registration

Online Registration Form 2024-2025

Creative Dance
Belchertown, MA
(413) 323-0096
creativedance.life@gmail.com

One form per student

Student's First Name

Student's DOB

Student's Last Name

Parent's Last Name

Parent's First Name

Mother's Cell

Address

Home Phone

City

Father's Cell

Zip Code

State

Email Address:

Contact Information

Relationship

Last Name

Phone Number

First Name

Emergency Contact Information

Allergies/Medical conditions

Student's phone number:

How did you hear about us?

Student's age

Year's of dancing

Grade entering into

Student's email address:

$25 Registration fee

New Student::

Returning Student:

Tap

Ballet

Jazz

Combo

Acro

Hip Hop

Lyrical

Pointe

Tech

Pips

Tap Team

Acro Team

Lyrical Team

Hip Hop Team

Jazz Team

Additional information

Nuggets

I agree

Liability Agreement

I have read, understand and agree to all the policies at Creative Dance.I release Creative Dance, Kathryn Scherr and all employees of Creative Dance of any liability or injury to my child before, during and after dance class. I understand that dancing is a physical activity and injuries can occur and do not hold Creative Dance, Kathryn Scherr or any employees or Creative Dance liable for any injuries to my child.

Select the desired class interes

Classes