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Kick It Out Summer On-line Enrollment Registration
Sign up for Dance classes for the 2019 Summer course offerings. Once submitted the Student(s) must submit a signed tuition agreement, signed Release of Waiver of liabilities, and a signed copy of the Guidelines and policies. Class fees due upon registration so if signing up on-line make sure to come into the studio office to make payment, see our office hours on our website or call 517-582--6784 to arrange a time. Or print off forms and drop in the mail, and it must be postmarked before set dates in order to receive any special prices.
Email address *
Student Name (1) *
Your answer
Student Name (2)
Your answer
Student Name (3)
Your answer
Student Age (1) *
Your answer
Student Age (2)
Your answer
Student Age (3)
Your answer
Parent 1/Guardian Name *
Your answer
Parent 1 Cell Phone
Your answer
Parent 1 Home Phone
Your answer
Parent 1 E-mail Address *
Your answer
Parent 2/Guardian Name
Your answer
Parent 2 Cell Phone
Your answer
Parent 2 Home Phone
Your answer
Parent 2 E-mail Address
Your answer
Mailing Address
Your answer
Additional Emergency Contact Name
Your answer
Phone Number
Your answer
Relationship
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Student's School (s)
Your answer
Request for Separate Parent information
Competitive/Non Competitive (Recreational)
How did you find out about Kick It Out? *
Date of Registration *
MM
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DD
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YYYY
Student 1 - Class choices *
Your answer
Student 2 - Class choices
Your answer
Student 3 - Class choices
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Payment Options - Choose One that applies *
Choose Applicable discount that may apply to your student
Referral name(s)
Your answer
On-line signature
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