|
|
|
|
| | |
|
|
Enjoy a 7 week introduction to the magic of dance! ballet, jazz, musical theater, hip hop and tumbling
|
|
Event: |
|
|
Start Date/Time: |
End Date/Time:
|
|
Fee per Student:
|
Room:
|
|
* - denotes required fields |
|
Family Information |
|
|
|
| | | |
| | | |
|
Students entered below will be added to your family's account
|
|
Add New Student #1:
(Show-Hide Details)
|
|
Add New Student #2:
(Show-Hide Details)
|
|
Add New Student #3:
(Show-Hide Details)
|
|
Add New Student #4:
(Show-Hide Details)
|
|
Add New Student #5:
(Show-Hide Details)
|
| | | |
|
Additional Information: |
|
| | | |
|
Release of Liability
(Show-Hide Details)
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.
|
|
|
Fees
(Show-Hide Details)
$99 Registration fee includes 7 week session . All sales are final and nonrefundable.
I've read the above and agree.
|
|
|
Make Ups
(Show-Hide Details)
One make up can be done per session. Please call our Customer Care desk at (619) 585-1133 to schedule your make up at our Eastlake Location at 870 Jetty Lane, Chula Vista, CA. 91913
I've read the above and agree.
|
|
|
Photo Release
(Show-Hide Details)
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.
|
|
| | | |
|
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:*
|
| | | |
|
Please Wait...
|
|
| |