BSBA Registration

Bell Shoals Baptist Academy

Complete form below to create a new registration. Please complete a new registration form per dancer.
Dancer's Full Name

First NameLast Name
Gender
Birth Date

MonthDayYear
Current Age
Bell Shoals Teacher Name
Please list any Medical conditions or Allergies you feel we me need to know.
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Emergency Contact Name

First NameLast Name
Emergency Contact Phone

Area CodePhone Number
Class Selection
By Registering online you are agreeing to the Liability Waiver, Media Release, and Policies and Conditions as stated in our "Policies Form". Using the online tool is as legally binding as signing and intialing our policy page. Click the box to confirm that you agree to and understand our Liability Waiver, Media Release, and Policies and Conditions.
In order to secure your child's spot in any of our classes your annual Registration Fee and 1st Tuition Payment must be received. ALL TUITION PAYMENTS MUST BE PAID DIRECTLY TO BSBA. .
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Regitrstion Fee$30.00

Family Registration Fee$50.00
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Bell Shoals Baptist Academy