Paramount Dance Academy - Fall 2024 Form
Complete the form below to register for our 2024-2025 dance season!
There is a non-refundable $25 registration fee charge per student to save your childs spot.
Sign in to Google to save your progress. Learn more
Student Name *
Student Birthdate *
MM
/
DD
/
YYYY
Grade Entering *
School Attending *
Classes Registering For:
(Please list class style, day & time)
 *
Number Of Dance Years Completed at Paramount:
Number of Dance Years Completed at any other dance studios:
Please advise us of any medical conditions we should be aware of:
Mailing Address (Street, Town, Zip Code) *
Parent 1 Name *
Parent 1 Cell Phone *
Parent 2 Name *
Parent 2 Cell Phone *
Parent Email Address (this will be used to send all studio correspondence) *
Secondary email address:
(Add another email here if you would like anyone else to receive studio information.)
I understand that dance classes may include, without limitation, dancing with props, stretching, barre work, across the floor combinations, dance routines in the center, and other related activities. I further understand that all of the activities of the dance class involve some degree of risk of strain or bodily injury. Paramount Dance Academy is not responsible for personal property. 

Please sign and date below:
 *
I understand I must keep a credit card on file.  I further understand all tuition payments are due by the 1st of the month.  All auto payment accounts will have their cards charged on the 1st of the month.  

Non auto payment accounts will have their cards charged on the 10th of month if your payment has not been received.  Payments made after the 10th of the month will incur a $10 late fee.  I further understand all withdrawals must be submitted in writing and completed before the 1st of the month in order to avoid further account charges. 

Please sign and date below:
 *
Credit Card Number
 *
Credit Card Expiration Date *
Credit Card Billing Zip Code *
Would like you to be placed on autopay?
Note: This card will be charged on the first of the month automatically if you select yes.
 *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms