Spend the Day With X Registration Form

Parent/ Guardian Info

For dancers under 18 ONLY. If you are over 18, skip down to Dancer's Info
Parent/Guardian's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:

Area CodePhone Number
E-mail*
Dancers' Info
Dancer's Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
E-mail: (Type N/A if dancer doesn't have one)*
example@example.com
Phone Number: (Type N/A if dancer doesn't have one)*

Area CodePhone Number
Address: (Enter Same as above if same a parent's)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What topics would you like to hear about?*

Rehearsal SchedulePricingPerformancesDifferent Levels of CommitmentOther
Sunday, November 26, 2025

12:00-1:00- Juniors Ballet ages- 10-13 (advanced 10 year old)1:00-2:00- Juniors Combo- ages 10-13 (advanced 10 year old)2:00-3:30- Skills and Drills w/ Mr. Ibn (Intermediate- Advanced)- ages 10 & up (advanced 10 year old)3:30- 4:30- Open Rehearsal (Learn Actual X Rep)- ages 10 & up (advanced 10 year old)
Tuesday, October 28, 2025

5:45-6:45- Hip Hop Combined- ages 10 & up6:45-7:45- Ballet 1 (Advanced)- ages 15 & up6:45-7:45- Ballet 2 (Intermediate)-ages 14-187:45-8:45- Modern 2(Intermediate) ages 14-18
Thursday, October 30, 2025

5:45-6:45- Tap Combined- ages 10 & up6:45-7:45- Jazz 1 (Advanced)- ages 15 & up6:45-7:45- Jazz 2 (Intermediate)-ages 14-187:45-8:45- Modern 1 (Advance) ages 15 & up
Saturday, November 1, 2025

Petites A Combo 1 (Ballet and Modern)- ages 5-7Petites A Combo 2 (Jazz and Hip Hop)- ages 5-7Petites B Combo 1 (Ballet and Modern)- ages 8-10 (beginner 10 year old)Petites B Combo 1 (Jazz and Hip Hop)- ages 8-10 (beginner 10 year old)Petites Acrobatics- ages 6-10 (beginner 10 year old)Acro Combined- ages 10 & up (advanced 10 year old)Open Rehearsal (Learn Actual X Choreography)- ages 5-10
Waiver

By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that the activities held at The X-Perience Dance Company are physical in conduct and could potentially result injury. I am aware of the potential risk associated with dance. However, XDC will not be held accountable in the event of a dance/ acrobatic or any physical activity related injury. Upon submission, any false statements, omissions, or other misrepresentations made by me on this application may result in immediate termination of services.
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Thanks so much for your expressed interest in sharing the day with us. We'll see you on the dance floor!
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Parent/ Guardian Info

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Waiver