Registration

Come join us for Diva and Dudes Camp! This Camp will be held June 12th and 13th from 10:00am- 12:00pm. This will include Ballet, Tap, Jazz, Tumble, with Arts and Crafts. Snacks will be provided.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Relationship to Student*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Is your Student in Miss Cindy's Daycare Dance program
Does your Dancer have any food allergies?*
If so, please list them here
 
Additional Information:
 
Assumption of Risk/Student Liability Release
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I've read the above and agree.
 
Payment Policy
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I've read the above and agree.
 
Social Media/Video/Photography Release
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I've read the above and agree.
 
Enter your Full Name: *   
 
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: