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Kick It Out Summer On-line Enrollment Registration
Sign up for Dance classes for the 2018 Summer course offerings for the month of June. 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. Or print off forms and drop in the mail, and it must be postmarked before set dates in order to receive any special prices.
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
/
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
Your answer
Submit
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