Copy of QCPA 23-24 Registration Form
2023-2024 Season
Registration Fee:
$50 Returning Student
$75 New Student
OK
*
1.
Student's Name
(Required.)
*
2.
Student's Date of Birth
(Required.)
*
3.
Mailing Address
(Required.)
*
4.
Primary Phone Number
(Required.)
*
5.
Email Address
(Required.)
*
6.
Parent/Guardian Name
(Required.)
*
7.
Emergency Contact Name and Phone Number
(Required.)
*
8.
Classes (Select Your Package or Desired Classes)
(Required.)
Pre-Ballet/Tap/Jazz (Ages 2-4)
Ballet
Tap
Jazz
Hip Hop
Contemporary
Broadway Dance
Acro
Pointe (For previous 2022-2023 pointe dancers or dancers who received an invitation for 2023-2024 season)
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9.
Tshirt Size
(Required.)
YXS
YS
YM
YL
YXL
AXS
AS
AM
AL
AXL
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10.
Medical Concerns or Allergies?
(Required.)