ELevate Enrollment

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Please complete the form below

Section One

Parental Information

Name

Parental Guardian (1)

First Name

Last Name

Phone

Cell Phone of Parental Guardian (1)

(###)

###

####

Name

Parental Guardian (2)

First Name

Last Name

Phone

Cell Phone of Parental Guardian (2)

(###)

###

####

Email Address

Family Email (This email will be used to deliver important information)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Section TWO

Child Information

Child's Name

First Name

Last Name

Birthdate

MM

DD

YYYY

Has your child ever danced, competed or enrolled with any other Oklahoma dance studios?

If answered "YES" to previous question, please list studio below

Section Three

Class Selection

Please select each class your child will be enrolling in.

(TUES) 5:30-6:30 Ballet

(TUES) 6:30-7:30 13 and up, Stretch & Tech

(WED) 4:30-5:15 Tap & Ballet Combo (3/5 YRS OLD)

(WED) 5:15-6:00 Hip Hop (3/5 YRS OLD)

(WED) 6:00-6:45 Tap & Ballet Combo (6/8 YRS OLD)

(WED) 6:45-7:30 Hip Hop (6/8 YRS OLD)

(THURS) 5:00-5:30 12 and under, Stretch and Tech

(THURS) 7:30-8:30 Ballet

Section FOUR

Signature / Parent Consent

Signature

First Name

Last Name

Signature Date

MM

DD

YYYY