Beginning Contemporary/Hip Hop

STUDENTS NAME: *

NAME OF PARENT/GUARDIAN: *

STUDENTS AGE: *

BEST PHONE NUMBER: *

EMAIL ADDRESS: *

REGISTERING FOR: *

CONTEMPORARY CLASS

HIP HOP CLASS

BOTH CLASSES

A 50% deposit is due at the time of registration. The balance will be due the first day of class. Payment may be made through Venmo (Mary Avara@dancenter) or credit card. You may also pay by credit card, check or cash at the studio during business hours (Mon.-Thur. 4:00-7:30 pm)

Credit Card Number;

CVV:

Expiration date:

Address and Zip Code:

I will send payment by: *

Venmo

Drop off at Dancenter Salisbury

Credit Card information provided on this form