Registration
ASDC MIGHTY MINI INTENSIVE - SESSION 2 - IN STUDIO !! July 6th, 7th & 8th (3 days) Time: 1:00am-3:30pm *SPACE IS LIMITED Fee of 225.00 + HST includes all three days. Student registration is required for the first day only.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Mother*
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 provide my credit card information below and I hereby authorize Art & Soul Dance Company to charge my credit card a one-time purchase in the amount of $254.25.*
 
Additional Information:
 
Release of Liability
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I've read the above and agree.
 
Release of Liability
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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:
Country:
City: State/Prov: Postal Code: