Hip Hop 2
Instructor: Ms. Gillian Ages: 7yrs-12yrs/ $20.00 Registration Fee / $ 80.00 per month/ 1 Hour Class
Dress Code:
All Hip Hop courses require form fitted sweats, Jazz shoe slip-on black split sole NOT full sole and hair 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 $80.00 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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Tuesday 5:45pm - 6:45pm
Child's Name:
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First Name
Last Name
Child's Date of Birth:
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Month
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Day
Year
Date
Are there any Allergies/Medical Issues we should be aware of:
blanks
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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.
Submit
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