Registration Form 2023-2024

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

* Required fields
E-mail Address *
Today's Date *
Dancer's Full Name *
Address *
City *
State *
Zip Code *
Birthdate *
Age *
Gender *
Grade for 2022-2023 School Year *
Home Phone *
Cell Phone *
Work 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 *
AUTO CHARGE Payments will be withdrawn from the 23rd to the 28th of the previous month for the month ahead. Tuition and costume payments will be withdrawn.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 *