Registration
Pre-School Summer Registration form. . Questions: Email info@livingartsdance.com. Please disregard the date at the top and use the dates in the checked box.
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 Info (Not Contact #1 or #2)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Summer Mini Session 5 Weeks: July 15th - August 12th*
Registration Fee $55.00 includes uniform, 2022 - 2023 current students do not not need to pay an additional registration fee.*
5 week session: 1 class $125, 2 classes $200. Example: 2 classes Ballet & Tap, Hip-hop & Acro
Class: Saturday, 9 am Mommy/Daddy & Me - Ballet & Tap Ages: 3 - 5*
Class: Saturday, 10 am Mommy/Daddy & Me - Creative Movement Age: 2 - 3*
Class: Saturday, 11 am Mommy/Daddy & Me - Hip-hop & Acro Ages: 3 - 5*
NUMBER OF CLASSES ATTENDING? (Example: Ballet & Tap, Hip-Hop & Acro = 2 classes)*
TOTAL PAYMENT DUE: (Registration Tuition= Total, Example: Registration 1 class = $180)*
 
Additional Information:
 
Attire
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I've read the above and agree.
 
Agreement
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I've read the above and agree.
 
Liability Waiver Part 1
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I've read the above and agree.
 
Liability Waiver Part 2
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I've read the above and agree.
 
Peanut Free Dance Studio
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I've read the above and agree.
 
Photo Release
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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:
City: State: Zip:*