Registration for fall classes are now being accepted!! Register online to reserve placement. Please do not delay as classes are filling up quickly! If you are human, leave this field blank.Online Registration Form: Please register online to reserve placement for any of our programsComplete Your Information:Please complete all required information Email *InstructionsPlease complete the following form. You can select one or more classes. This will reserve your spot in our class(es). Someone from our office will then contact you regarding payment. Thank you for registering and welcome to the Dance Academy of Prince Rupert! DateAddressApt, suite, etc.CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabweCityStateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces (AA)Armed Forces (AE)Armed Forces (AP)American SamoaGuamNorthern Mariana IslandsPuerto RicoUS Minor Outlying IslandsUS Virgin IslandsZip codePhoneCell PhoneFirst and Last Name of Dancer *Date of Birth (Month/Day/Year)GenderFemaleMaleGuardian (1) First and Last Name *Guardian (2) First and Last NameMedical Conditions or Special NeedsPlease list any allergies, medical conditions or special needs the Studio should be aware of.New to Dance Academy? How did you hear about us?Word of Mouth ( friends/family)NewspaperLocation/ SignageSocial Media (ie Facebook, Instagram)Online (Web Page)PosterRecital or other community performancesPlease check one or more boxesRegular season classes:Rhythm & Dance (ages 3-4) Tue 10:00-10:45amRhythm & Dance (ages 3-4) Wed 1:15-2:00pmRhythm & Dance (ages 3-4) Sat 10:00-10:45amTumbling Toddlers (ages 3-4) Wed 11:00-11:45amPower Movers (BOYS ages 3-5) Sat 11:00-11:45amPre-ballet (ages 5-6) Tue 3:45-4:30pmBallet Rec 1 (ages 7-8) Thu 6:00-6:45pmBallet Rec 2 (ages 9+) Fri 3:30-4:30pmJazz Rec 1 (ages 5-8) Sat 12:00-12:45pmJazz Rec 2 (ages 9+) Tue 3:30-4:30pmTap Rec 1 (ages 5+) Thu 3:30-4:15pmAcrobatic Dance Rec 1 (ages 5-8) Fri 4:30-5:30pm WAITLISTAcrobatic Dance Rec 1/2 (ages 5+) Fri 5:30-6:30pm Hip Hop Rec 1 (ages 5-8) Tue 4:30-5:15pm Hip Hop Rec 2 (ages 9+) Tue 5:15-6:15pm Song & Dance (ages 6+) Wed 5:30-6:30pmHighland (ages 8+) Thu 5:45-6:45pmModern (ages 10+) - **two ballet class requirementAdult Jazz Wed 6:45-7:45pm Adult Ballet Tue 6:15-7:15pmSilver Swans (55+ Adult Ballet) Mon 10:00-11:00amI'm interested in the DANCE TEAM, please contact me to set up an appointment.FREE TRIAL CLASS!I'm not sure, please contact me about class selection.Sessional ClassesToddler & You! Tue 11:00-11:45am - Sep 13-Nov 1 - Ages 1.5-3yrs - $110Adult Tap - Thu 6:45-7:45pm - NO CURRENT SESSION - Coming in 2023!!Additional InformationPlease use this space to inform us of any additional information regarding your dancer or to address any questions or concerns regarding registration or classes. We will contact you with a response as soon as possible:)Liability and ReleaseAgreeLiability: The Dance Academy of Prince Rupert, its’ proprietor, or those in its’ employ are not liable for any injury, sickness or disability which occurs due to the physical activity of dance; any loss of or damage to personal property, whether it be at the studio, competition, event or travel. I exempt, release and indemnify the Dance Academy of Prince Rupert and any and all persons related to the Dance Academy of Prince Rupert from any and all liability claims, demands, or causes of action whatsoever from any damage, loss or physical injury to myself or my participating minor child. Release of Information: I hereby give the Dance Academy of Prince Rupert permission to release my personal contact details to staff and parent volunteers for the purpose of contacting me regarding my participation in the Dance Academy of Prince Rupert. I hereby give the Dance Academy of Prince Rupert permission to use my/my child’s photo and name for the purpose of advertising in the local newspaper, printed materials, and on the website and social media. I AGREE AND ACCEPT THESE TERMS. COVID LIABILITY RELEASE AGREEMENT: Due to the 2019 outbreak of the novel Coronavirus (COVID-19), I affirm that I, or my minor child, will not knowingly attend class or events having been exposed to, diagnosed with, or exhibiting symptoms of COVID-19. • I understand that the Dance Academy of Prince Rupert cannot be held liable for any exposure to the COVID-19 virus. • I agree to each statement above and release The Dance Academy of Prince Rupert from any and all liability for unintentional exposure or harm due to COVID-19. By registering with the Dance Academy of Prince Rupert, you agree that you have read, acknowledge, understand, and agree to our Terms and Conditions.SubmitCaptcha *reCAPTCHA is required.CheckboxCheckbox
