Student Registration

Student Class Registration

2024 Fall
Student Class Registration

First Name

Last Name

Gender

Female

Male

Age

Date of Birth

Grade

Street Address

City/State/Zip

Phone

School Currently Attending

Time of Dismissal

Parent/Guardian Contact Information

Mother/Guardian's Name

Mother/Guardian's Cell Phone

Father/Guardian's Name

Father/Guardian's Cell Phone

Mother/Guardian's Email

Mother/Guardian's Other Phone

Father/Guardian's Email

Father/Guardian's Other Phone

Do you know of any classes your child will need to miss this semester? If so, please give dates.

Is there any specific information we need to know about your child? (Medications, Allergies, Shyness, Physical Limitations, etc.)

Terms and Conditions

By checking the box below, I consent for myself/my child to participate in dance classes and associated ministry events offered by Zion Center for Worship and the Arts/Resurrection Dance Ministry. I realize I must also sign a ZCWA/RDM Liability Waiver, Policy Statement, and Media Release Form prior to my/my child's first class.

I agree to the terms & conditions stated above.

Your registration is not complete until

your tuition payment has been received.

Student Class Registration

2024 Fall Student Class Registration

Parent/Guardian Contact Information

Terms and Conditions

2024 Fall
Student Class Registration