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
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
MONDAYS AGES 6-18 4:00pm
GIFT Certificate
$
80.00
Give The gift of dance good for four 30 minute classes
SELF DEFENSE MONDAY 5pm
$
80.00
Ages 18 +
LATIN BALLROOM MONDAY 6pm
$
80.00
Adult class
ONE CLASS
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Enter coupon
Apply
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Parent/guardian Signature
Submit
Should be Empty: