Alpha & Omega Dance Academy - Online Registration 2018-2019
Welcome to online registration for Fall 2018 - Spring 2019! If you have any questions or concerns, be sure to contact us at
or give us a call at 910-860-1405. Thank you for choosing us as your school of dance!
Student Date of Birth
If you are registering additional members of the same family, simply list the additional name(s) below, along with their DOB(s).
Parent Name (if student is under 18yo)
E-mail Address (Mandatory - all statements and info are paperless)
Best Number To Reach You:
Emergency Contact Number
We'd love to follow you on social media! (Please leave your Facebook/Instagram handle)
How Did You Find Out About Us?
I am a current member
Referral (if referral, please list name below)
Referred By (if applicable)
This person receives a discount upon the first month of your enrollment!
Page 1 of 3
Never submit passwords through Google Forms.
This form was created inside of Alpha & Omega Dance Academy.
Terms of Service