Summer Class Registration

Summer 2019 Class Registration

June 3rd - August 24th
Registration*

New StudentReturning Student
Payment for the month of:

JuneJulyAugust
Choose Start Date*

MonthDayYear
Date
Student's Name*

First NameLast Name
Age*
"A" for Adults
Grade
if applicable
School
List any allergies or medical conditions the school needs to be aware of
Will sibling also be attending?*

YesNo
Student's Name*

First NameLast Name
Age*
Grade
if applicable
School
List any allergies or medical conditions the school needs to be aware of
Parent/Customer Name*
Contact Number*
Email*

Confirmation EmailInvoices and other school notices are sent to emails on file
Address*

Street Address

Street Address Line 2

City

Zip Code
Emergency Contact Name*

Same as aboveOther
Emergency Contact Number*

Same as aboveOther
Once a week*

2 hour1.5 hour
1.5 hour Classes*

Tuesday 4:30 pm - 6:00 pmTuesday 5:00 pm - 6:30 pmThursday 4:30 pm - 6:00 pmThursday 5:00 pm - 6:30 pm
2 hour Classes*

Tuesday 4:30 pm - 6:30 pmThursday 4:30 pm - 6:30 pmSaturday 10:00 am - 12:00 pm
I give my permission for my child's / my photo and artwork to be used in promotional material. Only first name, last initial and age will be used for credit line.
How did you hear about us? Please check all that apply*

Internet SearchDriving ByFacebookFriend ReferralOther
Additional Comments/Notes

Tuition & Fees

New Student Registration Fee$30.00

Students

Monthly - 2 hour$145.00

MONTHS (per student):

Monthly - 1.5 hour$135.00

MONTHS (per student):

Sibling Discount$-10.00

Summer Semester - 2 hours$385.00

Quantity

Summer Semester - 1.5 hour$360.00

Quantity

Single Class - 2 hour (NOT trial class)$35.00

DAYS (per student)

Single Class - 1.5 hour (NOT trial class)$32.75

DAYS (per student)

Total $0.00

Summer 2019 Class Registration