be at
least 5 years
old. No dance
make ups
available.
OFFICE USE
ONLY
TOTAL DUE
CASH $
CHECK #
CC #
EXP
____/____
CODE_______
___
Make
ups are
only
done
during
our open
gym.
Student
must
_______ Make
ups – No refunds,
discounts or pro-rates
if the student is absent.
3rd session Feb 1st- May 22nd
1st session Aug 31st- Nov 30th
2nd session Dec 1st- March 31st
o
ff
i
c
e
i
s
n
o
t
n
o
ti
fi
e
d
_______ Dropping Class – you must notify the office before the 1st of the month
if not continuing into the next session. Fees will apply if
_______ Diamond Fees – all
fees are non-refundable, no credits will
be issued
for
any reason
PLEASE INITIAL EACH LINE
FIRST NAME:___________________________________
DOB___/___/____
LAST NAME:___________________________________
Class Day Time
Class Day Time
Class Day Time
Mult Class Disc
Registration Fee
35
TOTAL
Terms & Conditions
CHILD #
3
FIRST NAME:___________________________________
DOB___/___/____
LAST NAME:___________________________________
Class Day Time
Class Day Time
Class Day Time
Mult Class Disc
Registration Fee
35
TOTAL
Cell#
Address_________________________City/State_________Zip_________________
Home Number E-mail____________________________
EMERGENCY #_____________________NAME_____________________ (3rd party please)
CHILD # 1
FIRST NAME:___________________________________
DOB___/___/____
LAST NAME:___________________________________
Class Day Time
Class Day Time
Class Day Time
Mult Class Disc
Registration Fee 35
TOTAL
CHILD # 2
Cell #
Dad's Name____________________________________
DIAMOND REGISTRATION
DB____________ZIP__________TB RF_____________QB__________
ALL FEES ARE NON-REFUNDABLE
DATE____/____/____
Mom's Name_____________________________________