Registration
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Termination Notice: To terminate your class at the end of the month, please ensure your request is received by the 26th of the preceding month. Important: Log into your customer portal by clicking "Already a Customer..." to ensure your request is registered in your child's account. Please disregard the start and end date listed on the form. Use this form to cancel your current class. Answer the questions below and specify the month you wish to discontinue. Thank you.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Aunt/Uncle
Brother
Father
Grandparent
Guardian
Mother
Nanny
Other
Owner/Director
Parent
Sister
Step Father
Step Mother
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Allow child photo Yes/NO:
*
Notes :
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Allow child photo Yes/NO:
*
Notes :
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Allow child photo Yes/NO:
*
Notes :
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Allow child photo Yes/NO:
*
Notes :
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Allow child photo Yes/NO:
*
Notes :
Questions/Options:
Month you would like to stop
Today's Date
*
Child's Current Class, Day & Time
*
Reason for Termination
*
Your Name
*
Best phone number to reach you
*
Special Request/Notes
Additional Information:
Credits or Refunds
(Show-Hide Details)
I understand that there are No Refunds or credits for early termination requests.
I've read the above and agree.
Termination Date
(Show-Hide Details)
I understand that this Termination is request for the end of the month and must be received no later than the 26th of the month.
I've read the above and agree.
Membership Termination Status
(Show-Hide Details)
After the effective termination date, monthly tuition will not be charged and students will not be allowed to attend class.
Students that have been Terminated will be NOT be placed on a Student waiting list for any future return date.
Students who are terminated are not considered active members and are not eligible for any Member Benefits or Discounts even if siblings are enrolled.
I've read the above and agree.
Return to Class
(Show-Hide Details)
Return to any classes is not guaranteed and is subject to availability.
If a return to classes is desired, a new registration is required using the customer portal.
Intermediate and advanced students who have not attended classes for more than 3 month must be evaluated before returning to an intermediate or advanced class.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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