Michele Compa Fall 2025 Registration Form

Fall 2025 Registration Form

This registration form is for both adult and child dance and exercise classes. Registration fee is $35 per student, $45 per family.
Parent or Student's Name*

First NameLast Name
Student/Child's Name*

First NameLast Name
Student's Age*
Student's Birthdate*

MonthDayYear
Register a Sibling Below:

At checkout please, select "Sibling Registration Fee".
Sibling Name (if registering another child)

First NameLast Name
Sibling Age (if registering another child)
Sibling Birthdate (if registering another child)

MonthDayYear
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Family Email:*
example@example.com
Cell Phone:*
Please enter a valid phone number.
Home Phone:
Please enter a valid phone number.
Alternate Phone:
Please enter a valid phone number.
IMPORTANT

As of January 15th, 2023, all credit card transactions are subject to a 3% convenience fee. If you would like to pay with cash/check to avoid this fee, on the next page after selecting your desired class(es), use the coupon code "CASH" at checkout. You will still need to input a CC to submit your form however you will not be charged. Your registration is NOT FINAL until payment is received. Please make an appointment with Michele to drop off your check or pay in cash at the studio. You must make payment within 10 business days for your registration to be final or forfeit your spot in the class.
How did you hear about Michele Compa Dance and Exercise Center?*

Returning StudentFriendFacebook GroupNewspaperFacebook AdOther

Desired Classes:*
Desired Classes for Sibling (if applicable):
IMPORTANT

As of January 15th, 2023, all credit card transactions are subject to a 3% convenience fee. If you would like to pay with cash/check to avoid this fee, on the next page after selecting your desired class(es), use the coupon code "CASH" at checkout. You will still need to input a CC to submit your form however you will not be charged. Your registration is NOT FINAL until payment is received. Please make an appointment with Michele to drop off your check or pay in cash at the studio. You must make payment within 10 business days for your registration to be final or forfeit your spot in the class.

My Products*

Registration FeeFor one child. If registering a sibling, please add the "Sibling Registration Fee" below

$35.00 Quantity

Sibling Registration FeeChoose this if registering a sibling (Registration Fees are $35 per student or $45 per family)

$10.00 Quantity

Full Tuition PaymentFall Semester: Sept. 15th - January 31st

$435.00 Number of Classes you are Registering For (siblings included)

Two-Payment Plan (Balance due November 1st 2025)Fall Semester: Sept. 15th - January 31st

$225.00 Number of Classes you are Registering For (siblings included)

Trial Class(can be deducted from tuition)

$24.00

Adult Classes

$22.00 Exercise Class

Adult Dance Classes(10 classes)

$220.00

Private Lessons

$100.00

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

Warranty of Fitness and Agreement to Limitation of Liability: I hereby certify that I am physically capable of participating in this exercise program designed by Michele Compa Dance and Exercise Center. I have no physical disability, impairment, or ailment that would prevent me from engaging in such active or passive dance exercise programs; nor do I have any physical conditions which should detrimentally aggravate. Furthermore, I agree that I shall participate in classes and use the facilities entirely at my own risk and agree not to hold Michele Compa or any of her employees liable for any injury or damage which may occur to me in the above said class. I also understand that classes paid for must be taken within the session period. Class monies may not be credited toward future sessions. There are no refunds without an authorized medical excuse.*

Clear
Parent Signature
Should be Empty:

Fall 2025 Registration Form

Register a Sibling Below:

IMPORTANT

IMPORTANT

Credit Card