The Viera Studio
(321) 426-8229

Online Registration

Use the form below to register online. Already registered? Click here to pay for classes online.

Your Child's Information
Child's Name *
Child's DOB * (MM-DD-YYYY)
Your Information
Your First Name *
Your Last Name *
Cell Phone ( ) - *
Home Phone ( ) -
Email *
Class Information
Classes












Special Programs
   
Pickup Information The following people are allowed to pick up my child:
Pickup Person 1: Name
Pickup Person 1: Phone ( ) -
Pickup Person 1: Relationship
Pickup Person 2: Name
Pickup Person 2: Phone ( ) -
Pickup Person 2: Relationship
Additional Pickup People or Information
Medical Information
Emergency Contact *
Child's Doctor
Child's Doctor Phone ( ) -
Child's Medical Information (Allergies, Medication, etc)
Other Information
How Did You Hear About Us?
Additional Comments or Message
Legal Information
Do you consent to the use of my child’s image; such use may include all VSPA Publications (print, online, video, etc.). Such photographs would highlight the students either learning or performing? *

* Please Complete All Required Fields *

Important Notes

Once you complete the registration you will be taken to a page where you can pay the one-time registration fee and select child's t-shirt information.

Already registered? Pay for classes online by clicking here.

Have you registered but have not paid the one-time registraton fee and picked your child's t-shirt yet? Click here to do that.

Viera Florida Dance Studio