Registration

Summer Dance Camp for ages 4 - 8 Monday, July 6th - Friday, July 10th 9 am - 3 pm
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Account
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Does your child have any allergies/medical conditions of which we should be aware?*
Is your student currently enrolled at Touch of Class Dance Studio?
 
Additional Information:
 
PAYMENT
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I've read the above and agree.
 
REFUND
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I've read the above and agree.
 
HOLD HARMLESS WAIVER
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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:*