Withdrawal Form
Which program are you withdrawing from?
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Please Select
Recreational Program
Competition Program
Dancer’s Name
*
First Name
Last Name
Parent/Guardian On Contract
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Today’s Date
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-
Month
-
Day
Year
Date
Per our contact and studio policy, we require a 3 day notice and tuition UP TO CURRENT must be paid to close your account. This means that tuition up to the date of completing this form must be paid.
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Yes, I acknowledge this agreement and have paid tuition up to current.
Yes, I acknowledge this agreement and will submit my tuition payment up to current online
Yes, I acknowledge this agreement and will submit my tuition payment via Venmo or cash app.
By Signing below you agree that you have made all payments up to current and understand that the withdrawal and cancellation of contract will go into effect 4 weeks from today’s date upon receiving your withdrawal fee.
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Reason for withdrawal:
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We are always looking to improve our programs and facility. How could we have made your experience better?
Submit
Submit
Should be Empty: