Classy Divas Registration Form

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Parent Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

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Phone Number* This field is required.

Please enter a valid phone number.

4

Are you registering more than one dancer?* This field is required.

YESNO

5

Student Name* This field is required.

First Name

Last Name

6

Diva's Date of Birth?* This field is required.

Date

7

Do you need to add another student?

YESNO

8

Student 2* This field is required.

First Name

Last Name

9

Diva's Date of Birth?* This field is required.

Date

10

Do you need to add another student?

YESNO

11

Student 3* This field is required.

First Name

Last Name

12

Diva's Date of Birth?* This field is required.

Date

13

My Products* This field is required.

My Bag

1

Registration FeeThis is a one time, non-refundable fee.
$35.00Edit
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Quantity
Subtotal: $0.00

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By checking 'I Agree' on the following page and submitting this form, you, the Parent or Guardian of the above student(s), agree to release "M&T Performing Arts", including instructors and assistants from liability for any and all injuries which may occur while training, practicing, performing, or during any studio event or activity. You also agree that you are responsible for health and accident insurance and any medical costs incurred due to injury. You give permission for emergency medical transportation and treatment of your student(s) at your expense should the need arise. You also give your permission for the public display of any studio visual images that your child may appear in.

You understand that registration fees are non-refundable and cover only the period selected for payment. This applies even if your child(ren) decides that she/they no longer want to dance.

15

Do you agree to the terms and conditions listed?* This field is required.

I agree

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Payment Methods

Debit Or Credit Card

Please click one of the PayPal options to complete payment and submit the form.