LA FAME STUDIOS Dance Class Registration Form
Www.LAFAMESTUDIOS.com
BARBRA CLASS SCHEDULE
MONDAY 4:15BVVV
MONDAY 5:15 SELF DEFENSE MONDAY 6:00 LATIN DANCE
Student Information
Name of participant
Name
First Name
Last Name
Age
*
Gender
Male
Female
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
ANY Allergies or medication
Parent/Guardian Information
For minors (below 18 years of age)
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Relationship
*
Miscellaneous
Select the class you are registering for
*
MARTIAL ARTS 6-18 MONDAY
SELF DEFENSE ADULT CLASS MONDAY
LATIN DANCE ADULT CLASS MONDAY
Other
How many classes a week
*
1
2
3
4
5
Do you want to add enroll more students?
Yes
No
Additional students
Payment & Confirmation
Payment Method
*
Credit Card
Check
Cash
Other
Signature
Parent/guardian
First and last Name
Contact #
My Products
*
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FREE CLASS EVERY FIRST SATURDAY
Free
$
Free
STAY FIT SAT burn cardio 11:30 Princess camp 12:30 Princesses camp 1:00 Ballet for beginners 2:00 MARTIAL ARTS 2:30 SELF DEFENSE 3:15 LATIN DANCE 4:00pm
MARTIAL ARTS
$80.00
$
80.00
MONDAYS AGES 6-18 4:00pm
GIFT Certificate
$80.00
$
80.00
Give The gift of dance good for four 30 minute classes
SELF DEFENSE MONDAY 5pm
$80.00
$
80.00
Ages 18 +
LATIN BALLROOM MONDAY 6pm
$80.00
$
80.00
Adult class
ONE CLASS
$25.00
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$0.00
$
0.00
Enter coupon
Apply
Total
$0.00
$
0.00
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Parent/guardian Signature
Submit
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