Mary Jo's Performing Arts Academy Online Registration

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Welcome to Mary Jo's Performing Arts Academy online registration! Please provide your information below and click Submit when complete. Credit Cards are NOT charged at this time in order for our office to review your enrollment and make sure proper placement and discounts are applied. If you have any questions before registering, please feel free to email info@mjpaa.com

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info

Health Insurance Carrier

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # *

Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name*

Last Name*

Type*

How can we contact you?

Home Phone

Work #

Cell # * Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Disabilities-please explain

Special Needs

Allergies

Medications-please explain

Any Further Health Information

Below please click the "Search" tab in order to display the class listing. The class listing contains class descriptions and other information. We offer over 200 classes a week. If you don't see a specific class you are interested in or aren't really sure what you or your child wants, please don't hesitate to call 813-969-0240

Enroll in Classes

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Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Disabilities-please explain

Special Needs

Allergies

Medications-please explain

Any Further Health Information

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Disabilities-please explain

Special Needs

Allergies

Medications-please explain

Any Further Health Information

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Disabilities-please explain

Special Needs

Allergies

Medications-please explain

Any Further Health Information

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from Mary Jo's Performing Arts Academy. Standard message and data rates apply. Reply STOP to opt out

Additional Info

Student Email

T-Shirt Size*

School*

Grade Level*

Disabilities-please explain

Special Needs

Allergies

Medications-please explain

Any Further Health Information

Enroll in Classes

Select Class *

Add Another Student

Required Policies

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Questions or Concerns

Comments

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Account Information

Autopay Options*

Please fill out CREDIT CARD Payment Method

Credit Card

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Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

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Student #2 (Show-Hide Details)

Additional Info

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Student #3 (Show-Hide Details)

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Student #4 (Show-Hide Details)

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Questions or Concerns

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Credit Card

eCheck/Bank Draft

Required Policies

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