Registration

Come take Contemporary with Ms. Heather Pre-Pay $15 ahead of time, and $20.00 at the door! Class Schedule: We will host three classes. Once we see enrollment we will send out designated schedule to have equal class sizes. 4:30-5:30 5:30-6:30 6:30-7:30
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact*
 
 
Students entered below will be added to your family's account
 
Additional Information:
 
 
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:*