Chrome Dance Centre OnLine Registration
RequiredRequired Question(s)
Required 1.

Student's First and Last Name:

 

50 characters left.
Required 2.

Student's Date of Birth (mm/dd/yyyy):

 

50 characters left.
3.

Parent or Guardian's First and Last Name (if student is under the age of 18):

 

50 characters left.
Required 4.

Family Address:

 

350 characters left.
Required 5.

Family Phone Number (please note whether cell or home):

 

50 characters left.
Required 6.
Email Address:
By entering my personal information, I consent to receive email communications from Chrome Dance Centre based on the information collected.
 

50 characters left.
7.
What class(es) are you interested in?:
 

350 characters left.