Registration

A creative dance adventure as we journey through the the world of Disney!
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Click to Enter an International Number Cell #: Click to Enter an International Number Work #: Click to Enter an International Number
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
Camp Deposit
I understand that a $75 deposit fee is due per student per camp upon enrollment. This deposit will be applied to the $200 camp fee. If I cancel the camp after enrollment, I will then forfeit the deposit.
I've read the above and agree.
 
Camp Payment
I understand that full payment of the camp balance is due on the Friday before the first day of camp. If the balance is not paid in full by this time my credit card on file will automatically be charged for the remaining balance.
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:*