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Welcome to Princess Academy! where your little Princess will have an enchanted time between story time, crafts and dance!!
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Event: |
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Start Date/Time: |
End Date/Time:
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Fee per Student:
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Room:
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* - denotes required fields |
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Family Information |
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Students entered below will be added to your family's account
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Add New Student #1:
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Add New Student #2:
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Add New Student #3:
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Add New Student #4:
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Add New Student #5:
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Additional Information: |
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Release of Liability
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I hereby release Neisha's Dance & Music Academy, Inc. and its contractors from any claim for damage or suit by reason of injury, illness, or damage to person or property during the course of the dance program. In case of emergency or sudden illness, I hereby five authority to any hospital or doctor to render immediate emergency aid as it might be required for the undersigned student's health and safety. Neisha's Dance & Music Academy, Inc. DOES NOT carry medical insurance for its students. It is required that all students be covered by their own family insurance and if injury occurs, it is understood that the student's own policy is you only source of reimbursement.
I've read the above and agree.
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Fees
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$15 per each Princess Camp or $49 for all 4 Princess Camp . All sales are final and nonrefundable.
I've read the above and agree.
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Photo Release
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I understand and acknowledge that, during the program my child's picture and/or video might be taken while participating in class or function involving ND&MA I do hereby authorize Neisha's Dance & Music Academy to use these photographs or videos for purposes of illustration, advertisement, social media and publication in any manner whatsoever1
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: * |
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Name as it appears on card: * |
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Nickname:
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Card Expiration Month: * |
Exp Year: *
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Address Line 1:
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Address Line 2:
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City:
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State:
Zip:*
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