Summer Stages Enrollment Form

Register Now!
Parent/Guardian Name *

First Name Last Name
Email *
example@example.com
How did you hear about mainstages FUN-inars?

Email Facebook Instagram Word of Mouth Google Search Referred by a Friend (List friend's name below)
How many participants are you registering for? (Price is per screen, but we want to get to know everyone who will be joining our FUN-inars!) *
Participant #1 Name & Birth Date *

Child's Name Child's Birth Date
Participant #2 Name & Birth Date

Child's Name Child's Birth Date
Participant #3 Name & Birth Date

Child's Name Child's Birth Date
Participant #4 Name & Birth Date

Child's Name Child's Birth Date
Participant #5 Name & Birth Date

Child's Name Child's Birth Date
Anything else we should know? Leave it here!

Register for mainstages FALL FUN-inars: *

mainstages: LIVE! 7-Class Package $ 105.00

Wednesdays from 4-5 PM EST *NO CLASS 12/30*

mainstages: LIVE! 3-Class Package $ 45.00

Wednesdays from 4-5 PM EST *NO CLASS 12/30*

mainstages: LIVE! Drop-In Classes

Wednesdays from 4-5 PM EST

Date	Select	Price
January 6th		$ 18.00
January 13th		$ 18.00
January 20th		$ 18.00
January 27th		$ 18.00
February 3rd		$ 18.00
February 10th		$ 18.00
February 17th		$ 18.00

Enter coupon

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

TERMS AND CONDITIONS

By pressing submit you acknowledge that there will be no refunds after the first class. You are agreeing to attend only the classes registered and paid for by submitting this form. You and/or your child agree to respect our community guidelines around respectful behavior on Zoom, as stated in the PDF you'll receive with your welcome email.
I agree that photo and/or video content may be used for promotional purposes
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