Registration

Walnut Street Theatre Camp
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:
Would you like after care? If so, which days?
Does your child have any allergies/medical conditions of which we should be aware?*
How many years of dance experience does the dancer have?
Is your student currently enrolled at Touch of Class Dance Studio?
 
Additional Information:
 
PAYMENT
I authorize Touch of Class Dance Studio to automatically charge my account on file on June 3, 2019 or within 2 business days of registering if after 6.3.19 . MasterCard, Visa, or Discover can by used for payment.
I've read the above and agree.
 
REFUND
NO REFUNDS WILL BE GIVEN 5 DAYS PRIOR TO THE START OF THE DANCE CAMP.
I've read the above and agree.
 
HOLD HARMLESS WAIVER
I hereby fully release and discharge "Touch of Class Dance Studio", owners, directors, and staff from any and all claims from injuries, damage or loss which I (or dependents under 18 years of age) may have or which may accrue to me (or dependents) which may result or arise in connection with his/her participation in classes, workshops, camps, or any other studio function.
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:*