Dance Friends

Are you or someone you care for an individual over 14 with special needs, who is not part of a support or social group? Register at the form below and someone from our team will contact you to set up a virtual dance class FREE OF CHARGE. Through 45 minutes of guided instruction, the class aims at bringing fun, freedom and expression to the dancers, while preserving the integrity of the artform.

*Please note we are NOT licensed therapists. We are dance professionals with extensive work around special clients.
**When filling the form below, all information should pertain to the participant taking the dance class. Only put their information unless the field specifically indicates someone else’s.

Participant Name

First Name

Last Name

Email - best email for correspondence, even if of caregiver

Phone - best number for calls, even if of caregiver

(###)

###

####

Birth Date

YYYY

Have you used Zoom before?

Your Time Zone (I.e. EST, CST, MST, PST)

Dance Genre

Below, check any that apply that you would like to learn with us

Ballet

Modern

Hip Hop Style

Best Days

Please list 2 best days of the week that work for you to have the class, and at which windows of the day. (Write which hours would work.)

Music Restriction

Music used during class reflects the dance style. There is no profanity. If you have any restriction for religious or other purposes please let us know below.

Favorite Music

Write in your favorite bands or songs. While we default to music that appropriately reflects your dance style, we can incorporate your favorites into the class.

Birthday MM/DD/YYYY

Injury or Special Conditions

If you have any specific injuries, please describe them here. If you do not have injuries, please write "NA" You may also choose to write any special conditions here if you would like. We celebrate your unique qualities and wish to tailor the class to the best that it can be for you!

Full name of caregiver filling out this form if not participant

Liability Waiver

By checking this box I confirm that I have read and understood and agree to all terms of service outlined on https://www.artist-house.org/liability-waiver