CCDC Summer Registration

Capital City Dance Center is currently accepting class registrations during an exciting new transition. You will be contacted with an update shortly.

Thank you for your interest!

Register now for Summer 2017 classes at Capital City Dance Center.

Annual registration fee is $20.00 for students new to CCDC.
Please mail check to CCDC, 2962 99th Street, Urbandale, IA 50322.

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Family Information
Parent Name*
Zip Code*
Phone Number*
Email Address*
Confirm Email Address*

Student Information
Student Name*
Date of Birth*
Student Sex* MaleFemale

Summer Programs
Summer Intensive Both Weeks: (June 5 - June 16)   Monday-Friday
Summer Intensive Week 1: (June 5 - June 9)   Monday-Friday
Summer Intensive Week 2: (June 12 - June 16)   Monday-Friday
Summer Workshop: (June 19 - July 25)

Select the desired Summer Workshop classes from the list below

Class Selections Indicate level, day, and times
(e.g. Level 4 Mon 7:00-9, Level 4 Thurs 6:30-8)
Creative Movement/PreBallet

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Click on CLASSES for days and times


1. * Release from liability: I do hereby release Capital City Dance Center and its staff from any liability occurring on or around studio premises, or at any function held at other locations in connection with the dance classes in which the student named above is enrolled. I declare that the student named above is in good health and can participate in dance education classes. Given the nature of dance classes, and with the knowledge that injuries sometimes might occur, I have taken the necessary steps to obtain accident, health, or hospitalization insurance which would cover any sustained injury. In the event of an injury or emergency when I cannot be contacted, I give my permission for you to obtain medical services for the student named above.

2. * Authorization for enrollment: I authorize Capital City Dance Center to enroll the student named on this form in dance classes, and I accept responsibility for the payment of tuition for those classes for which the student is registered. I understand that classes with an enrollment of less than six pupils are subject to cancellation.

3. * I understand that the curriculum fee for annual classes is non-refundable and that there are no refunds or deductions for classes not attended.

4. * I understand that if I do not give written notice of the student’s withdrawal from classes by the 15th of the month, I am obligated to pay the next month’s tuition.

By submitting this form I agree to items 1, 2, 3, and 4 above.

Please mail or deliver $20 registration fee to: Capital City Dance Center,
2962 99th Street, Urbandale, IA 50322


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