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Registration Form

Please complete the requested information for each child. Please include your email address, since you will need it to log in and access your information online. Most of our contact is done through email. Thank you.

NOTE: If you have entered your information before, do not fill out this form! Update your information here instead.

Password you want to use to access your information

The following characters are not allowed in passwords: < > * $ %
For your security as well as ours, we require passwords to be a minimum of 8 characters and use a combination of uppercase letters, lowercase letters, and numbers. Please write down your password in a safe place so you won't forget it.

New Students: Please tell us how you heard about ABDC.

Parent/Guardian 1

First name Last name

Address

City State Zip

Primary phone:   Secondary phone:

Email address

Parent/Guardian 2

First name Last name

Fill out any information below that is different from Parent/Guardian 1.

Address

City State Zip

Primary phone: Secondary phone:  

Email address

Emergency Contact

Name    Phone

Student 1

First name Last name

Date of Birth (mm/dd/yyyy)  Grade in school, Fall

New student: please describe your dance experience:

Returning student: this will be my year dancing at A-B Dance Center.

I grant Acton Boxborough Dance Center permission to use my child's photo for promotional purposes without identification or notification.

If this child has a medical condition and/or allergies worth noting, please describe the condition and medications:

ADD ANOTHER STUDENT