Registration
ROCK STAR CAMP - ON ZOOM!! Tuesday July 21st to Thursday July 23rd (3 days) Fee of 99.99 + HST includes all three days. Student registration is required for the first day only. *Login info will be sent the day prior to the first day of camp*
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Parent/Guardian*
Home Phone:* Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State/Prov: * Postal Code: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
I AGREE TO ONE OF THE PAYMENT OPTIONS BELOW ***A 'yes' or 'no' answer to all questions is required.*
I authorize Art & Soul Dance Company to automatically charge my credit card on file.*
I DO NOT have a credit card on file with Art & Soul Dance Company and understand that in order to register for and participate in the ROCK STAR CAMP I must enter my credit card information below.*
Prior to this event, an INTERAC e-TRANSFER for full payment will be sent to artandsouldancecompany@rogers.com.*
 
Additional Information:
 
Release of Liability
  (Show-Hide Details)
I've read the above and agree.
 
Release of Liability
  (Show-Hide Details)
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:
Country:
City: State/Prov: Postal Code: