Registration/ Payment Form

Registration/ Payment Form

Please Fill out with the dancer's information first.

You may use this form to do the following:

*REGISTER for dance class/classes

*MAKE A PAYMENT on your TTP account.

* Required fields
Name *
E-mail Address *
Address *
City *
State *
Zip Code *
Birthdate *
Age
Grade for this school year
Home Phone *
Work Phone *
Cell Phone *
Parents'/Guardian's Name(s): *
Allergies/medical conditions that we should be aware of:
Payment Information *	Visa MasterCard Discover
Credit Card Number *
Expiration Date *
security code on back of card *
Billing Zip Code *
Please choose the one that best decribes what you are visiting us for today: *
Description of Payment: *
Class that I would like to sign up for and that I have already checked availability on by checking the fall 2011 schedules page to make sure that my desired class is not in red print. If it is in RED print then that class is currently closed and not available at this time. PLease check availablity before signing up. Thanks!
Upon typing in my name or the legal guardian's name of the above dancer, I understand that taking Dance lessons can result in injury. I realize that my child or I will be well-supervised while attending classes at To The Pointe of Performing Arts, but in the case of an accident, I will not hold To The Pointe, it's teachers, directors, or assistants liable for any and all damages or injuries caused by participating in classes/recitals/events at To The Pointe of Performing Arts Inc.. *

I have read and agree to the Privacy Policy *

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