Star Dancers Program Form
Thank you for your interest in Dance Elements Exceptional Steps Class. We are excited to have your dancer try dance class with us. By completing the form below you will allow us to be prepared to give your dancer the best experience possible.
Email address *
Phone Number: *
Your answer
Parent Name: *
Your answer
Dancer's Name: *
Your answer
Dancer's Age: *
Your answer
What is your dancer's diagnosis?
Your answer
How does your student communicate? *
Required
Will your student need a personal assistant for class? *
Will your student bring a personal assistant to class? If so, what is his/her name? *
Your answer
Tell us one think your dancer likes/enjoys outside of dance. *
Your answer
Has your dancer taken dance class before? *
What are your dancer's triggers? *
Your answer
What are some coping strategies your dancer uses successfully? *
Your answer
Is there anything else you would like us to know about your dancer?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service