National League of Junior Cotillions

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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 West Volusia County 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, Heather LeFils, 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.

Refund * There will be no refunds given except in the case of extraordinary circumstances such as moving or illness in fairness to the students who are on the waiting list.

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 by check

*an online handling fee of 5.4% will be added to PayPal payments.

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Director’s Home

National League of Junior Cotillions
West Volusia County Chapter

Registration

Please refer to the CLASSES page for class dates, times and locations, if you are uncertain of the appropriate class to register for.

Once you submit your registration, please check your email. You will find an email confirmation containing information regarding payment.

Thank you for registering with The Volusia County Chapter of The National League of Junior Cotillions!

2025-2026 Student Information

2025-2026 Student #2 Information

2025-2026 Student #3 Information

2025-2026 Student #4 Information

2025-2026 Student #5 Information

2025-2026 Student #6 Information

About the Parents

Younger Siblings