Mommy & Me Ballet/Jazz
Instructor: Ms. Gillian Ages: 3yrs-6yrs/ $20.00 Registration Fee / $ 70.00 per month/ 45-minute Class
Dress Code:
All Jazz/Ballet courses require leotards and footed tights. Ballet requires Split Sole ballet slippers with elastics and Jazz requires Jazz shoe slip-on black split sole NOT full sole. Hair should be pulled back into ponytail or bun.
Registration & Payment Information:
There is a $20.00 registration fee. Registration Forms are only accepted when accompanied by payment. If you submit a registration form without payment your child is not considered registered, and their spot will not be held. Payment is $70.00 monthly and can be submitted by Venmo: Virginia Dill @virginia-dill or PayPal: 757-717-7187. Please include your child's name, class day and time on payment.
Select Class Day & Time:
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Mommy & Me Ballet, Monday 6:30pm - 7:15pm
Mommy & Me Jazz, Wednesday 6:30pm - 7:15pm
Child's Name:
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First Name
Last Name
Child's Birthday:
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Month
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Day
Year
Date
Are there any Allergies/Medical Issues we should be aware of:
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Home Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's Name:
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First Name
Last Name
Mother's Email:
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example@example.com
Mother's Phone Number:
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Please enter a valid phone number.
Father's Name:
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First Name
Last Name
Father's Email:
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example@example.com
Father's Phone Number:
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Please enter a valid phone number.
Emergency Contact #1 Name:
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First Name
Last Name
Emergency Contact #1 Email:
example@example.com
Emergency Contact #1 Phone Number:
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Please enter a valid phone number.
Emergency Contact #2 Name:
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First Name
Last Name
Emergency Contact #2 Email:
example@example.com
Emergency Contact #2 Phone Number:
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Please enter a valid phone number.
I understand that if my registration fee is not submitted in full on the same day as my registration, my registration is null and will be deleted from submissions.
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