Registration
October 14th-18th 8 am-12:00 , ages 5-11yrs of age, Fun and learning through the Art of Dance, Music, Karate and Art. Guided through Our Trained Staff and helpful assistance. $10 off early registration before September 30th. $ 100 First camper $75 each additional. Extended Stay till 4:00 is available, $50 extra per student( bring lunch) snack will be provided.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Will your students be extended stay? Extended Stay is until 4:00 $50 per student *
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*
 
 
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: