Brickhouse NYC Hip Hop Summer Intensive Registration Form
Dancer's Name
*
First Name
Last Name
Dancer's Age
*
Parent/Guardian Age (if under 18)
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Summer Intensive Group
*
Week 1: Ages 13 & under - August 12th - 16th
Week 2: Ages 14 & over - August 19th - 23rd
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Summer Intensive
$
495.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
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