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MOHAWK VALLEY DANCE THEATRE
2020-2021 Season Student Online Registration Form
Please complete one form for each individual student. Payment will be due at your first class, either in cash or through our online portal. Links to online payment will be made available shortly before classes begin. Tuition agreement is for monthly payments only at this time. A waiver will be sent to you through e-mail and must be printed and signed to bring with you for the first day of classes. Before registration, please make sure you have read and understand the
studio policies,
updated
uniform
, and
COVID-19 related regulations.
*
Indicates required field
STUDENT INFORMATION
Name
*
First
Last
D.O.B.
*
MM/DD/YYYY
Email
*
Phone Number
*
Do you wish to receive text alerts in the case of closings/inclement weather?
*
Yes
No
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Is the student currently registered and active at MVDT?
*
Yes
No
Current students are participants in the 2018-2019 season in good standing. A $30 Registration Fee is required for all new students, or students who have been inactive for any length of time.
MVDT or CAPA Alumni?
*
Check here if you are an alumni.
Due to the restricted class sizes based on NYS regulations, we cannot offer the alumni discount for the 2020-2021 season.
Phone Number
*
PARENT/GUARDIAN OR EMERGENCY CONTACT INFORMATION
parent/guardian #1 name
*
First
Last
Email for #1
*
Phone Number #1
*
parent/guardian #2 name
*
First
Last
Email for #2
*
Phone Number #2
*
Who else has permission to pick up the child?
*
please check if student is 12 or older and is permitted leave the premises alone
*
Yes
No
If not checked, a listed parent or guardian must come in the building to pick up the child.
Please note, due to COVID-19 restrictions, we are a drop-off only facility. Any students under age 12 must be picked up and dropped off at the door by a parent or guardian at this time.
CLASS INFORMATION
If you are unsure of the student's level or class selection, please contact the director prior to completing this form.
All level and class placements are the sole discretion of the director.
Choose LEVEL
*
Level 1
Level 2
Level 3
Level 4
Level 5
Choose PROGRAM
*
Level 1A (Tiny, Age 3 & 4) Mondays 4-4:45 pm Ballet & Acro Combination
Level 1B (Mini, Age 5 & 6) Mondays, 5-5:45 pm Ballet & Acro Combination
Level 2A (Ages 7-9) Thursdays, 4-5:30 pm Ballet, Jazz & Acro Combo
Level 2B (Ages 9-11) Wednesdays, 4-5:30 pm Ballet, Jazz & Acro Combo
Level 3/4 (Ages 12+) N/A
Level 4/5 (Ages 12+) Tuesdays, 4:30-7:30 pm Ballet, Jazz & Modern
Level 3/4/5 (Ages 12+) Mondays, 6:30-7:30 pm Acro Dance
Alternative Program (Not Listed)
Please use this field for any additional information you wish to communicate to our director or instructors.
*
Please leave this field blank if you have no additional i
I agree to receiving marketing and promotional materials
Submit
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