Student Information

Student Name

Student Date of Birth

Grade in School (2026-2027 school year)

Receiving Trophy in June 2027 (3,5,8,10,13,15 years of dance)

Address

City

Zip

Home Phone

Home Email

Student Cell Number

Parent Information

Mother's Name

Mother's Work Phone

Mother's Cell Phone

Mother's Email

Father's Name

Father's Work Phone

Father's Cell Phone

Father's Email

Classes

Class Choice

Recreational Pre-Competition (audition required) Competition (audition required)

Class Choice

For Non-Competing Students -
Do you wish to be an Unlimited Student?

Payment Information

Registration Fee: $50 first student / $30 each additional student in the family.
There is a 3% fee added for all credit/debit card transactions.

Credit Card Number

Expiration Date

CVC Code

Address for Card

City

Zip

How did you hear about Northland?

Health History

Please list any health issues

Room Parent

Are you an organized person that would like to be involved in your dancer's class as the Room Parent? Room Parents receive a monthly tuition discount. If you have been selected as Room Parent, you will be informed prior to the first lesson in September. There will be a meeting to learn how to effectively be a Room Parent. If you are interested, please sign up below.

Your Name

Your Email

Important Requirements for All Groups

I agree my dancer will perform in all performances and events in which their group participates.

I agree to purchase costumes necessary to the group. (including shoes, tights, and make-up.

I know the P3 monthly fee is a commitment from start date to the end of the season.

I agree if I discontinue lessons after the 1st of the month, I will pay for the full month with no refunds if costumes have been ordered. I agree to pay for them in full.

COMP I, II, & PRECOMP ONLY: I am aware that if my dancer(s) quit after audition results are announced, there will be a $100 credit card fee charged to my card.

I give Northland School of Dance permission to use my picture or my childs picture for advertising purposes.

I'm aware that if choosing to pay with a credit card, will be be charged an additional 3% processing fee per transaction.

I agree to the above statements

Yes No

New dancers, please stop by the studio to receive a tour and meet our staff.

No confirmation of your registration is necessary. You will be notified if there is a change to your class. Classes begin September 8th.

I hereby release all persons affiliated with Northland School of Dance from any and all claims for damages or injuries which may be sustained while participating in any and all activities connected with Northland School of Dance. I also agree to adhere to all policies of Northland School of Dance.

By your response below, and providing your name and clicking 'Register' you are agreeing to use this as an electronic signature.

I understand the above information, and I have filled out this form accurately and completely to the best of my knowledge. I understand that by not accepting any part of the terms and conditions, it may not be possible to be accepted in a class or competition company.

Typing Your Name Below Will Be Considered Your Electronic Signature

Ready to register for the 2026/2027 Dance Season? Fill out our Registration Form below:

Student Information