Registration
Please register for Parent's Night Out. Once you register and it comes through on our end we will charge the card on file for $15.00 for the event. If you have any questions please call us at 704-494-8952 or we can be reached by email at fuzionforceea@gmail.com Thanks,
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Is your child a Fuzion Force Dancer?*
Does your child have any allergies or medical conditions we should be aware of? If yes, please explain.*
 
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:*