Homeschool/Daytime - TBS Registration Form

Parent's Name *

Student's Name *

Student's Birthdate *

Phone *

Email *

Any allergies or medical conditions we should know about? *

Which class would you like to register for? *

Ages 3-6 Daytime Ballet Thursday 1:30-2:15 PM

Ages 7-12 Daytime Ballet Thursday 1:30-2:15 PM

Please read and check off the following: *

I acknowledge that monthly automatic drafts will be debited starting on the first day of class and will continue on the same day each month until May, unless I call to cancel this arrangement.

I understand that I am required to either visit the front desk or call to provide my payment method information, and I hereby authorize the organization to automatically debit my account each month for the designated payments.

Optional - I hereby grant permission for the use of my child's likeness and image on social media and marketing materials for promotional purposes related to the program or organization.

Payment *

Dance Year Registration Fee

$50

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