BBDC Registration

To register, please fill out the online form and then visit our store for class selection and payment.

You can also print our Registration Form and submit it to the studio in person.

Student First Name:*
Student Last Name:*
Contact Email:*
Student Date of Birth:*
Age:* Grade (Fall 2025):*
Street Address:*
City:*
State:* Zip:*
Parent #1 Name:*
Parent #1 Phone:* Parent #1 Cell/Work Phone:
Parent #2 Name:
Parent #2 Phone: Parent #2 Cell/Work Phone:
Emergency Contact:*
Emergency Relation:*
Emergency Contact Phone:*
Any medical condition we should be aware of:

Release Waiver

I, the undersigned Parent or Guardian of the above student, release BROADWAY BOUND DANCE CENTER, including instructors and assistants, from any and all injuries which may occur from training, practicing, performing and/or during any event or activiity. I also agree that I am responsible for the health and accident insurance and any medical costs for the above student incurred due to injury including, but not limited to, emergency medical transportation and treatment if the need arises. I understand that BBDC has a NO REFUND policy. If a student drops, the account will be creadited the remaing balance and will be saved for up to one year. I also give my permission for the public display of any studio pictures that my child may be in.

I have read and agree to the Broadway Bound Dance Center Waiver terms:     CONFIRM*

Parent Name:*
Parent Signature:* Date:*