Step It Up Dance- Participant Registration Form - 2025
Please complete this form to ensure your enrollment in Step It Up Dance Fall/Winter.

If you are an adult 18+ enrolling in a program for yourself, please enter your information when participant information is requested. 

If you are enrolling your child in a youth program, please enter your child's information when we request participant information.  
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Which program are you enrolling in?  *
If you would like to enroll in multiple programs, please complete the registration form for each program you would like to enroll in. 
What is the first name of the participant? *
What is the last name of the participant? *
Is the participant a new student or returning student for Step It Up Dance? *
What is the date of birth of the participant? *
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What city does the participant live in? *
What is the participant's address?
If the participant lives in East Palo Alto, what neighborhood do they live in? *
Does the participant have any allergies?  *
If the participant has allergies, please list and inform us of any pertinent information (such as needs an inhaler). If the participant does not have allergies or any special health conditions, please write N/A *
Does the participant have any disabilities or accommodations the staff should be aware of? *
If the participant does not have any disabilities or need special accommodations, please write N/A
How did you hear about Step It Up Dance? *
Does the participant have previous dance training? If yes, please list.  *
What is your preferred mode of communication  *
Required
What is the first and last name of the participant's parent or participant's emergency contact? *
What is the First Emergency Contact's relationship to the child? (ex- mother, father, uncle, aunt, sister guardian) *
What is the email of the participant's parent or participant's emergency contact? *
What is the phone number of the participant's parent or participant's emergency contact? *
What is the first and last name of the participant's second parent, guardian, or participant's second emergency contact? *
What is the email of the participant's second parent, guardian, or participant's second emergency contact?
What is the phone number of the participant's second parent, guardian, or participant's second emergency contact? *
What is the participant's gender? 
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