Registration

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Welcome To RGVAS, Here is your chance to explore all we have to offer. New to our Studio for ages 3-6yrs. of age. No uniforms are needed. Shorts or leggings and a T-shirt, and and Hair out of face. No Jewelry. Please bring your child at least 10 min before class to go to the restroom. Children more than 5 min late to class will not be allowed in" disruptive to the rest of class". Please pick your children up on time. At the end of July, let us know what class you would like to enroll in for the fall session.

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

Add New Student #1:

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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: