QCPA 22-23 Registration Form

2022-2023 Season

Registration Fee:

$50 Returning Student

$75 New Student

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* 1. Student's Name

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* 2. Student's Date of Birth

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* 3. Mailing Address

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* 4. Primary Phone Number

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* 5. Email Address

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* 6. Parent/Guardian Name

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* 7. Emergency Contact Name and Phone Number

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* 8. Classes (Select Your Package or Desired Classes)

Pre-Ballet/Tap/Jazz (Ages 2-4)

Ballet

Tap

Jazz

Hip Hop

Contemporary

Broadway Dance

Acro

Strength and Flexibility

QCPA 22-23 Registration Form

2022-2023 Season

Question Title

* 1. Student's Name

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* 2. Student's Date of Birth

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* 3. Mailing Address

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* 4. Primary Phone Number

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* 5. Email Address

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* 6. Parent/Guardian Name

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* 7. Emergency Contact Name and Phone Number

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* 8. Classes (Select Your Package or Desired Classes)

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* 9. Tshirt Size

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* 10. Medical Concerns or Allergies?