Jitterbug Performing Arts Pre-Registration Form:

Thank you for your interest in Jitterbug Performing Arts!

Please fill out one pre-registration form per child. After completing and submitting the information below, you will be redirected to the Jitterbug Performing Arts website to complete your registration and payment. You will receive a confirmation email that your pre-registration information was received, which will also include a link to complete your registration on the Jitterbug website in case you encounter any problems with the redirect from the Covenant website.

1.
*

Student Last Name:

2.
*

Student First Name:

3.
*

Grade Level:

K4
K5
1st Grade
2nd Grade
3rd Grade
4.
* Teacher:
5.
*

Parent Name(s):

6.
*

Phone Number:

* Email Address: