Registration Form for Jacksonville Centre of the Arts

Please fill out this registration form for your dancer at the Jacksonville Centre of the Arts. We need detailed information to ensure a smooth registration process. Thank you!

Dancer's First Name

Dancer's Last name

Parent(s) Name(s)

Dancer's Age

Home Address

Zip Code

Dancer's Phone Number

Dance Experience

Current Grade

School Attending

City

State

Parent Cell Phone

Parent Email

Do you have any current injuries or medical conditions that we should be aware of?

No current injuries or medical conditions

Yes, please specify below

Do you carry a needed medication?

No medication

If yes, please specify your needed medication

What is/are your goal or goals within the program?

How did you hear about JCA?

Do you have friends interested in our program? Please list their names and contact numbers.

Why do you want to train at JCA?

Who is allowed to pick up your dancer?

Level of Dance Enrollment

JCA Recreational

JCA Level I

JCA Level II

JCA Level lll

JCA Level lV

JCA Level V

JCA Level Vl

Dance Theatre

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