Director’s Home

National League of Junior Cotillions
Lexington District One Chapter

Registration

Thank you for registering your child with the National League of Junior Cotillions. We have received your registration form and have begun the process of enrolling your student. We accept tuition payments by PayPal ([email protected]), VENMO (NLJCLEX1) or personal check (made to NLJC- Lexington).

Currently, we require at least a $50 deposit fee (non-refundable) to hold your child's spot in our class. Of course, you are welcome to make a 1/2 partial or full payment to complete your registration and reserve your child's spot. We fill classes on a first-come, first-serve basis and require both payment and registration for enrollment. If you have any questions regarding enrollment, payment, or the registration process in general, please feel free to contact me at [email protected] or 803-960-7354.

I invite you to visit our website at www.nljc.com/chapter/lexingtonsc for further information on our local chapter including the dates for our classes this season. On that site, you will also find the link to our national website (www.nljc.com) where you can learn more about the National League of Junior Cotillions programs. You will find recent news, cotillion information, social dance videos, and much more. We have such an exciting season planned and truly look forward to another great season of etiquette, dancing, and fun!

2024-2025 Student Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

Add additional child to this registration »

2024-2025 Student #2 Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

Add additional child to this registration »

2024-2025 Student #3 Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

Add additional child to this registration »

2024-2025 Student #4 Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

Add additional child to this registration »

2024-2025 Student #5 Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

Add additional child to this registration »

2024-2025 Student #6 Information

Class Registering For*

First Name*

Last Name*

Preferred Name*

Gender * Male Female

Salutation

Street Address *

City *

State *

Zip *

What school will the student attend in the fall *

What elementary school did the student attend*

Current Grade *

Grade Entering In Fall *

Birth Date (format: 5/13/2011)

About the Parents

How did you hear about us?

Parent / Guardian 1 Salutation

Parent / Guardian 1 First Name *

Parent / Guardian 1 Last Name *

Parent / Guardian 1 Email Address *

Parent / Guardian 1 Email Address (Again)*

Parent / Guardian 1 Cell (or Preferred) Phone *

Parent / Guardian 1 Occupation

Parent / Guardian 2 Salutation

Parent / Guardian 2 First Name

Parent / Guardian 2 Last Name

Parent / Guardian 2 Email Address

Parent / Guardian 2 Cell (or Preferred) Phone

Parent / Guardian 2 Occupation

Photo and Video Release*

Please use the checkbox below to grant permission to the National League of Junior Cotillions and National League of Junior Cotillions Lexington District One Chapter to use photos and/or videos taken at NLJC events for any legal use, including but not limited to newsletters, publicity, and web content, UNLESS I notify the director, Melony Davis, in writing (with instructions and a photo of the child) before classes begin. The National League of Junior Cotillions will not use names or identifying information about students in any publication.

As the parent/guardian, I GIVE permission for images of my child(ren) to be used by The National League of Junior Cotillions in print or electronic materials as indicated above.

As the parent/guardian, I DENY permission for images of my child(ren) to be used by The National League of Junior Cotillions in print or electronic materials as indicated above.

Allergies * I understand the director will not be held responsible with respect to accommodating food-born allergies.

Note to Director

Payments I'll pay with PayPal* I'll pay with Venmo I'll pay by check

*an online handling fee of 4% will be added to PayPal payments.

Younger Siblings

We attempt to ensure that younger siblings receive an invitation to participate, once they have reached the appropriate age for cotillion classes. If interested, please provide some information about younger siblings.

Sibling 1 First Name

Sibling 1 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Sibling 2 First Name

Sibling 2 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Sibling 3 First Name

Sibling 3 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Sibling 4 First Name

Sibling 4 Last Name

Birth Date

Year entering fifth grade *

Elementary school child will attend

Please note: If your child has any special dietary restrictions or any conditions that would restrict their ability to participate in cotillion activities, please contact the director with those details.