Summer 2024 Registration Form
This form is for adult dance and exercise students as well as parents of students 18 years of age or younger, interested in taking dance classes. Registration fee is $35 per student, $45 per family.
Parent or Student's Name
*
First Name
Last Name
Student/Child's Name
*
First Name
Last Name
Student's Age
*
Student's Birthdate
*
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Register a Sibling Below:
At checkout please, check "Sibling Registration Fee".
Sibling Name (if registering another child)
First Name
Last Name
Sibling Age (if registering another child)
Sibling Birthdate (if registering another child)
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Home Address
*
Street Address
Street Address Line 2
City
State / 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 can 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 Student
Friend
Facebook Group
Newspaper
Facebook Ad
Other
Back
Next
Desired Classes:
*
Desired Classes for Sibling (if applicable):
Desired Summer Programs (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 can 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.
Summer 2024
*
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Registration Fee
For one child. If registering a sibling, please add the "Sibling Registration Fee" below
$
35.00
Quantity
1
Sibling Registration Fee
Choose this if registering a sibling (Registration Fees are $35 per student or $45 per family)
$
10.00
Quantity
1
Trial Class
(can be deducted from tuition)
$
24.00
Children's Classes
(based on 6 week Summer session July 9 - Aug. 16)
$
145.00
Number of classes per week you are registering for (siblings included)
1
2
3
4
Performing Arts Workshop
July 9 - Aug. 16 (2 day per week program)
$
474.00
Summer Dance Intensive
July 9 - Aug. 16 (2 day per week program)
$
575.00
Adult Dance Classes
(based on 6 week Summer session July 9 - Aug. 16)
$
117.00
Adult Classes
$
20.00
Exercise Class
Single Class
Ten Class Card
Twenty Class Card
Private Lessons
$
90.00
1 Hour
45 minutes
30 minutes
5 one-hour sessions
10 one-hour sessions
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.
*
Parent Signature
Submit
Should be Empty: