Fireworks Dance Center Sparkle Session Registration Form
Welcome to Fireworks Dance Center. You Belong Here. Thank you for your interest in Fireworks Dance!

Please complete one form per student. We'll contact you within one business day to complete the registration.

Session includes tuition for a weekly dance class for 3 months (class at correct age and skill level placement). To view our class calendar:

With our Sparkle Session Bundle, your dancer will get to choose a leotard (tutus included), tights, ballet shoes, a dance bag, a commemorative Fireworks Dance Center t-shirt, PLUS 3 months of classes (one class per week).
PLUS an incredible once-in-a-lifetime opportunity to DANCE ON THE STAGE at Philadelphia’s Love Park Christmas Village. Register by October 15, and your commemorative FDC Christmas Village sweatshirt (costume) is FREE (additional $30 value). Only $289 for everything you need to give your child the magic of dance and the thrill of dancing at the Christmas Village at Love Park.

A SPECTACULAR performance opportunity!
Register here today
Your Dancer's Information
Dancer's Full Name *
Your answer
Student's Birthdate *
Which Weekly Dance Class?
Select age-appropriate and correct level of class from the Fireworks Dance Class Schedule.
See the class schedule at
If you are unsure of the class level, we'll be happy to help select the appropriate class, and will reach out to you when we complete the registration process.
Dance Class You're Registering For (Please include dance style, day and time). *
Your answer
Your (Parent/Guardian) Information
Parent/Guardian's Name *
Your answer
Parent/Guardian's Mobile Phone Number *
Your answer
Parent/Guardian's Email Address *
Your answer
Mailing Street Adress *
Your answer
City *
Your answer
State *
Your answer
ZIP Code *
Your answer
Please note any disabilities, allergies or health problems we should be aware of
Your answer
Whom can we thank for referring you to Fireworks Dance Center?
(We love referrals! For NEW FDC students only. The referring FDC dance family recieves a referral credit for a new FDC dance family, if you stay as a paying family for at least one full month.)
Your answer
How did you hear about our studio? *
Please explain more: Who is the family/friend? Or at what event? Or what newspaper? Where did you see our flyer/ad?
Your answer
RELEASE OF LIABILITY: Activities at Fireworks Dance Center, Inc. are physical and with all physical activities, injuries are possible. I understand and will not hold Fireworks Dance Center, Inc. or its teachers responsible for any injury or loss that may occur. When sending your child to Fireworks Dance Center, Inc. I understand my child should be covered by my own insurance and I will not hold Fireworks Dance Center, Inc. responsible for accidents that may occur. It is agreed that participating in any class taught or organized activity at Fireworks Dance Center is undertaken at the sole risk of the student. Students, parents, and guardians hereby agree to hold harmless, release, and forever discharge Fireworks Dance Center, its employees, contractors, consultants, advisors, and owners from any and all claims for injury or damage to the student’s, parent’s, guardians’ and visitors’ person or property arising out of or in connection with participation in any event or class taught by Fireworks Dance Center and from all acts of active or passive negligence on the part of Fireworks Dance Center and any of its employees, contractors, consultants, advisors, and owners. *
PHOTO RELEASE: Fireworks Dance Center is given all rights to use photos/videos for promotional use. I give Fireworks Dance Center Inc. permission to photograph my child and to use the photographs around the facility and as a promotional tool. *
Please confirm confirm consent of above releases by entering your first and last name below *
Your answer
Any questions or comments?
Your answer
Thank you for registering for the Sparkle Session!
We'll be in touch within one business day. Feel free to call us (484-494-8700) or email us ( with any questions.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service