2022-2023 Registration Form
Performing Arts Academy of Virginia Beach
4402 Princess Anne Road, Suite 104
Virginia Beach, Virginia 23462

Visit us at www.performingartsacademyvb.com or www.facebook.com/performingartsacademyofvirginiabeach.

NEW FAMILIES: $25/child or $50/family NON-REFUNDABLE registration fee must accompany this form.

Please note you MUST fill out a separate registration form for each dancer!
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Email *
Student's Name *
Date of Birth *
Child's Age and Grade *
Street Address including City, State, and Zip Code *
Parent/Legal Guardian's Name *
Parent/Legal Guardian's Contact Number *
Email *
Optional Second Email
If an additional family member needs communication from the studio, please list their email address here!
Emergency Contact Name (besides parents/guardians) *
Emergency Contact Number *
Past Dance Experience *
Does your child have any dietary restrictions, allergies, or disabilities? If so, please indicate below. no *
How did you hear about us? *
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