Registration
We are so excited for you to join us for an exciting morning of Halloween, circus and dance! Join us for dress up, circus class, crafts and snacks on Saturday, October 18 9-10:15am. Wear your "circus friendly" Halloween costume.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email: (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
 
Other Questions/Comments:
 
Please fill out ONE of the following Payment Methods.
Credit Card Verification:
 
 
eCheck/Bank Draft:
Bank Name:
Bank Routing Number: (9-digit number)
Your Account Name: (Your name on your bank statement)
Your Account Type:   Account Number: