Benson Dance & Tumble Registration SOLINA

Join The Fun At SOLINA Dance Productions!
CHILD'S INFORMATION
Child's Name*

First NameLast Name
Child's Birth Date*

MonthDayYear
Child's Grade for the 2024-2025 School Year*
Child's Daycare/School For The 2025-2026 School Year?
MaleFemale
TUESDAY 5PM-5:55PM Twlights Dance/Tumble Ages 2.5YRS-4.5YRSTUESDAY 6:00PM-6:55PM Twinkles Dance/Tumble” Ages 5YRS-9YRS
SELECT YOUR CLASS

Choose your way to pay*

SOLINA Membership

SOLINA Dance Membership gives your dancer more than just weekly classes. Members enjoy access to our app with practice videos and updates, priority ticket access for showcases, early registration for programs and workshops, and a connected dance community. Join today and keep the joy of dance going year-round!

$29.00 Quantity

Season Subscription Weekly $15/wk

This dynamic class blends Ballet, Jazz, Hip-Hop, and Tumble, giving dancers a well-rounded and engaging experience. Don’t miss this opportunity for consistency, growth, and performance fun!

$15.00 Quantity

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Subtotal

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Tax

$0.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

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Child's T-Shirt Size*
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.*
GUARDIAN INFORMATION
Guardian Name*

First NameLast Name
Guardian Cell Number*
Format: (000) 000-0000.
Guardian E-mail*
example@example.com
Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
EMERGENCY CONTACT INFORMATION
Emergency Contact Name*

First NameLast Name
Emergency Contact Cell Number*
Format: (000) 000-0000.
Emergency Contact Relationship To Child*
SUBSCRIPTION GUIDELINES
I understand that this registration, tuition payments, and any additional fees are non-refundable, non-transferable and are not eligible for proration*
I understand that dance tuition is charged as a weekly subscription and fees are processed EVERY Sunday for the duration of the session.*
I understand to stop payments and cancel a subscription, I must submit the official withdrawal form. This form must be submitted at least 7 days before the future automatic draft date.*
I understand that no cash or payments are accepted at the Studio. All payments must be made with debit or credit card on file.*
I am agreeing that all charges are being made with my consent and permission. I understand that if a problem arises with my account I will contact the billing department and resolve the issue directly with SOLINA Dance Productions before filing a dispute, claim, and/or request chargeback with my credit or debit card issuer.*
I understand my child's tuition subscription payments is based on enrollment and NOT student class attendance. I understand that my child's account will be charged even if my child is absent from class.*
I understand that my child's FIRST dance tuition subscription will process on the Sunday of their first week of dance class. *
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Join The Fun At SOLINA Dance Productions!

CHILD'S INFORMATION

SELECT YOUR CLASS

GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION

SUBSCRIPTION GUIDELINES