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Please complete the form below

Student Information
Student Name *
Student Name
Student Date of Birth *
Student Date of Birth
Gender *
Student Home Address *
Student Home Address
Guardian Information
Guardian Name *
Guardian Name
The name of the person who will act as the student's account manager.
Guardian Phone *
Guardian Phone
Classes
Choose the classes or programs in which the student is interested.
Saturday Classes
On Saturday afternoons, we offer a variety of dance classes. Please select the classes the student wishes to take. Select all that apply.
We Are Hip-Hop After School Program
During the school week, we offer a three-day after school program from 2:30 to 6:00 PM. Please select the days that the student is interested in attending. Select all that apply.
Weekday Classes
During the week, we allow students to attend classes offered for the WAH after school program. Please select the classes the student wishes to take. Select all that apply.
Travel Team
The Lotus Travel Team is our youth dance company. The dancers commit to taking 4 classes per week and performing at events around NYC. If your child has experience dancing and is serious about performing, please indicate their level of interest. Admittance into Travel Team is at the discretion of the instructor.
Emergency Contact
The Emergency Contact cannot be the guardian listed above.
Emergency Contact Name
Emergency Contact Name
Emergency Contact Phone
Emergency Contact Phone