PLEASE PUT THE NAMES OF ALL YOUR DANCERS IN THE FIRST FIELD UNDER (NAME)

* Required fields
Name *
E-mail Address *
Address *
City *
State *
Zip Code *
Birthdate *
Age
Grade for this school year
Home Phone *
Work Phone *
Cell Phone *
Cell Phone Carrier (At&T, Verizon Sprint, T Mobile etc) *
Parents'/Guardian's Name(s): *
Auto Charge Enrollment (Mandatory): Card Holder's Name *
CARD NUMBER *
Expiration Date *
CVV CODE *
Billing Address for this card *
The first AUTO CHARGE payment taken out will be for the month of October. Payments will be withdrawn from the 23rd to the 28th of the previous month for the month ahead. Tuition and costume payments will be withdrawn. *

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I have read and agree to the Privacy Policy *