Michele Compa Summer 2024 Registration Form

Summer 2025 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 NameLast Name
Student/Child's Name*

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

MonthDayYear
Register a Sibling Below:

At checkout please, check "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 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 StudentFriendFacebook GroupNewspaperFacebook AdOther

Desired Classes:*
Desired Classes for Sibling (if applicable):
Desired Summer Programs (if applicable):
Desired Adult Dance & Exercise Classes (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*

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

Trial Class(can be deducted from tuition)

$24.00

Children's Classes(based on 6 week Summer session July 8 - Aug. 15)

$150.00 Number of classes per week you are registering for (siblings included)

Performing Arts WorkshopJuly 8 - Aug. 15 (2 day per week program)

$600.00

Summer Dance IntensiveJuly 8 - Aug. 15 (2 day per week program)

$600.00

Adult Dance Classes(based on 6 week Summer session July 8 - Aug. 15)

$126.00

Adult Classes

$22.00 Exercise Class

Private Lessons

$95.00

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

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:

Summer 2025 Registration Form