Registration
Form18104 102nd NE, Suite 104 - Bothell, WA 98011 - (425) 483-4272
Print
Name of Student:___________________________________________ Age(if under 16):______ Grade in School as of Sept. 2007:_______ Parent or Guardian Name:________________________________________ Email Address:_________________________________________________ |
| Do not write in this space Reg. pd______________ Check #_____________ Credit Card approval #________________ Total paid: _________________ Bal. due:_____________ |
| Mailing Address:_________________________________________________ _______________________________________________________________ City/State:______________________________________ Zip:____________ Home:(_____)_____________________ Cell:(_____)____________________ |
| Pay by phone with Visa or Mastercard (425) 483-4272 By Check By Cash |
| In case of emergency
call: Name:____________________________________ Phone:____________________ Cell:________________ |
List Dance Training:______________________________________________________________________ |
|
|||||
Class space is reserved. Therefore no refunds or credits can be given for missed or dropped classes or dance camps. Registration fee, deposits or tuition will not be refunded. The parent or
adult student signing this release acknowledges our policy as stated
on the tuition form and understands that his/her child or adult
student is taking classes at his/her own risk and agrees to hold
Cameo/Carrabba Dance Inc., its instructors, and/or assignees harmless
in the event of any physical injury to the student. Person signing
this form is responsible for payment of registration fee, camp fees
and/or tuition. Registration Fee is $30.00 per year. Please enclose with registration form. X________________________X______________________________________________________________ |