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PAC 2026-27 Dancer Registration Form

*Dancer's First name

*Dancer's Last name

*Birthday

Month

Day

Year

*Dancer's Age

Parent(s) Name

*Address

*Phone

*Email

*Class Selection Information (Performance Based)

Jitterbugs (Ages 2-3)

Young Dancers Ballet/Tap (Ages 4-5)

Young Dancers Ballet/Jazz (Ages 4-5)

Young Dancers - All Three Styles (Ages 4-5)

Ballet (Ages 6+)

Tap (Ages 6+)

Jazz (Ages 6+)

Hip Hop (Ages 8+)

Pre-Pointe (Ages 10+) *Or Instructor Discretion

Pointe (Ages 11+) *Or Instructor Discretion

JR Musical Theatre (Ages 8-13)

SR Musical Theatre (13+)

Adaptive Dance (Ages 8+)

Praise (Ages 13+)

Contemporary (Ages 13+)

Contemporary Jazz (Ages 13+)

Acting & Improv (Ages 8+)

Vocal Performance (Ages 8+)

Senior Workshop (Ages 15+)

Company (Ages 13-18) *Requires Audition

Class Selection Information (Non-Performance Based)

Acro (Ages 8+)

Stretch & Strength (Ages 11+)

Dance Fitness (Ages 18+)

*Dance History (have you had previous training? how much? what disciplines? where?)

What days are NOT preferred?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

What is the earliest time you can arrive for weekday classes?

Please list any other conflicting activities:

*Release: It is understood that PAC and its Staff will not be responsible for any injury/illness incurred during participation in classes/activities or travel to/from **(Parent's if under 18 yrs)

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2603 West Mercury Blvd. Hampton, VA 23666

(757) 827-4030

pachampton@gmail.com

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