Registration
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This Termination is for the End of the Month and MUST BE RECEIVED BY THE 15th OF THE SAME MONTH . YOU MUST CLICK ON "ALREADY A CUSTOMER..." to log into you customer portal to make sure that this request registers in your child's account. All Membership Termination Requests must be confirmed!
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Aunt/Uncle
Brother
Father
Grandparent
Guardian
Mother
Nanny
Other
Owner/Director
Parent
Sister
Step Father
Step Mother
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Date of Trial Class- $35.00 :
Desired Start Date for classes:
*
Notes :
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Date of Trial Class- $35.00 :
Desired Start Date for classes:
*
Notes :
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Date of Trial Class- $35.00 :
Desired Start Date for classes:
*
Notes :
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Date of Trial Class- $35.00 :
Desired Start Date for classes:
*
Notes :
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Nonbinary
Birth Date:
*
(format=mm/dd/yyyy)
Name of School:
*
Allergies and/or Medications (Leave blank if NONE):
:
Date of Trial Class- $35.00 :
Desired Start Date for classes:
*
Notes :
Questions/Options:
Today's Date
*
Child's Current Class, Day & Time
*
Reason for Termination
*
Your Name
*
Best phone number to reach you
*
Special Request/Notes
Additional Information:
Membership Duration
(Show-Hide Details)
I understand that students must have been a member for at least 3 full consecutive months by the termination date.
I've read the above and agree.
Credits or Refunds
(Show-Hide Details)
I understand that there are No Refunds or credits for early termination requests.
I've read the above and agree.
Termination Date
(Show-Hide Details)
I understand that this Termination is request for the end of the month and must be received no later than the 15th of the month, which is a minimum of the 2 weeks prior the requested end of month termination date in order to be accepted.
I've read the above and agree.
Membership Termination Status
(Show-Hide Details)
After the effective termination date, monthly tuition will not be charged and students will not be allowed to attend class.
Students that have been Terminated will be NOT be placed on a Student waiting list for any future return date.
Students who are terminated are not considered active members and are not eligible for any Member Benefits or Discounts even if siblings are enrolled.
I've read the above and agree.
Return to Class
(Show-Hide Details)
Return to any classes is not guaranteed and is subject to availability.
If a return to classes is desired, a new registration is required using the customer portal.
Intermediate and advanced students who have not attended classes for more than 3 month must be evaluated before returning to an intermediate or advanced class.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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