danceLogic Registration

Please note it is important that participants are committed to having regular attendance on Saturdays during the program schedule. We look forward to receiving your application.

Applicant Name(Required)

First Last

Date of Birth

Age(Required)

Name of the school you attend(Required)

How did you learn about danceLogic?(Required)

Tell us why you want to join the danceLogic Program.(Required)

Have you taken a dance class before? If yes, what type of class.(Required)

Have you had a computer programming/coding class before? If yes, what type of class.(Required)

Are you able to commit to regular attendance?(Required)

Yes

Your Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Parent/Guardian Phone(Required)

Date

Registration Fee

Price: $150.00

The one-time registration fee can be made in payments.

Registration Fee Waiver

I am unable to pay the registration fee, please send the waiver form.

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215-473-7810

5114 Parkside Ave, Philadelphia, PA 19131, USA