Break Free Hip-Hop School: Houston
Introductory Pass - Registration Form
Student Full Name
*
First Name
Last Name
Student Full Name (2)
First Name
Last Name
Student Full Name (3)
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Parent/Guardian Full Name (if student is under 18)
First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Notes - Please share any notes about your family/the students if you'd like:
Registration Fee
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Intro Pass - Houston Location
This unlimited 2-week pass gives you access to as many classes as you’d like during this introductory period. Book now and a Break Free specialist will follow up to guide you to your classes!
$
59.00
Quantity
1
2
3
4
5
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Payment Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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