Parent's Name *

Email *

Phone *

Child’s Name *

Child's Date of Birth *

*By filling out this form you are agreeing to receiving text messages from CORE Dance. Someone on our team will reach out via text within the next business day.

Child's Age Group

Ages 2-4

Ages 5-7

Ages 8-12

Ages 13+

Child's Name

Do you still have a child to take to the class?

Yes

No

Child's Name

Child's Date of Birth

Child's Age Group

Ages 2-4

Ages 5-7

Ages 8-12

Ages 13+

Do you still have a child to take to the class?

Yes

No

Child's Name

Child's Date of Birth

Child's Age Group

Ages 2-4

Ages 5-7

Ages 8-12

Ages 13+