I want to register for: *Ready, Set, AcroToddler GrooverParticipant InformationFirst NameLast NameBirthdayGenderselectFemaleMaleOtherPrefer not to sayIs the participant a current Acro Student at RDA?YesNoAllergies or Medications, Special ConsiderationsContact Information First NameLast NameRelationSelectParentGrandparentRelativeLegal GuardianEmail AddressAll important notices and updates will be sent via this email provided.Cell PhoneFirst NameLast NameRelationSelectParentGrandparentRelativeLegal GuardianEmail AddressAll important notices and updates will be sent via this email provided.Cell PhoneParticipant AddressAddressCityZIP / Postal CodeHome PhoneTax ReceiptTax AddressSame as AboveDifferent AddressNameStreet AddressCityState/ProvinceZIP / Postal CodeCountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweSession SelectionToddler GrooversSelectJanuary 11th Session, 9:15AMJanuary 11th Session, 10AMClassesNoneAcro Skills SessionsNone AvailableReady Set AcroJanuary SessionRegistration Terms & Conditions I agree to pay my fees in full via credit or debit card below. I understand there will be no refunds after December 1st, 2024. I agree that if my account is not up to date by March 25, 2025 interest charges will apply. After a third attempt, a collection agency will be contacted. I agree that the email address(es) I provided at registration is/are to be used for communication reasons. It is the recipients responsibility to make sure all communications are read - RDA is not responsible for emails going to SPAM or PROMOTIONS. Please check these folders BEFORE inquiring about a missed communication. Add us to your contacts/safe senders lists. I agree to inform a studio director or office manager if participant(s) withdrawals from Rivertown Dance Academy, via email or written letter. I give consent that the name of dancer, photos, and video footage taken during participation at the Rivertown Dance Academy may be used for promotional advertising including use in newspaper articles and social media. If you do not agree to the above photo consent please indicate on the registration page under “photo consent.” I agree should I have any complaints or concerns regarding Rivertown Dance Academy I will contact a studio director (Catherine Cristofaro, Laura Dufour) or the office manager. Only payments made by December 31st, 2024 will be reflected on your 2024 tax receipts from Rivertown Dance Academy Inc. Each receipt will be emailed to you and is considered legitimate for tax receipt purposes. Please keep them for your records. Please contact us if you have any questions.Terms and Conditions *Yes, I agree with the Terms and Conditions and our Privacy Policy including Terms of Service.Photo Consent *YesNoas noted in the Terms & ConditionsReceiving Email Communications *Select RecipientsTo Contact 1 OnlyTo Contact 2 OnlyTo Contact 1 & 2E-Signature *This field will serve as your electronic signature as final agreement to all terms and conditions unless otherwise noted.Subtotal$Taxes$Total$Submit Registration InformationPlease do not fill in this field.
