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Parents' Night Out: Enjoy a night out while we take care of the fun! Your kids will have a blast with games, crafts, dancing, a movie, and pizza. Leave the planning to us, and we'll make sure the kids have an unforgettable time!
Multi Family discount will be applied after registration and is $20 for each additional child.
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Event: |
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Start Date/Time: |
End Date/Time:
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Fee per Student:
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Room:
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Family Information |
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Students entered below will be added to your family's account
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Add New Student #1:
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Add New Student #2:
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Add New Student #3:
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Add New Student #4:
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Add New Student #5:
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Additional Information: |
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Release of Liability
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On behalf of the minor, I acknowledge and agree that participation in activities at Lyrique Dance subjects the minor to the possibility of physical illness or injury. By participating, I assume all risks associated with such participation.
I've read the above and agree.
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Sick Policy
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Students and adults entering the building must show no signs of fever or vomiting in the past 24 hours.
I've read the above and agree.
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Medical Emergencies
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On behalf of the Minor, I acknowledge and agree that such participation subjects Minor to possibility of physical illness or injury and that I, in my own behalf and on behalf of Minor, acknowledge that Minor is assuming the risk of such illness or injury by participating in the Activities.
I've read the above and agree.
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Withdrawal
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A written notice via email is required to cancel event enrollment. Cancellations made less than one week prior to the event are non-refundable. In case of an emergency, a credit will be issued. If Lyrique Dance cancels a class due to low enrollment, a refund will be provided.
I've read the above and agree.
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Other Questions/Comments: |
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Credit Card Verification: |
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Card Number: |
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Name as it appears on card: |
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Nickname:
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Card Expiration Month: |
Exp Year:
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Address Line 1:
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Address Line 2:
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City:
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State:
Zip:
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| eCheck/Bank Draft:
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Bank Name: |
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Bank Routing Number: |
(9-digit number)
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Your Account Name: |
(Your name on your bank statement)
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Your Account Type: |
Account Number:
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