TPC Young Adult Hip Hop Dance Experience Registration
Thank you for choosing TPC!!! Please complete the form below. There is a $25 fee (which will be applied towards the session's tuition) due to secure your spot in the class. This fee is due after you complete this form, but PRIOR to the start of your first class. All tuition fees are due no later than the end of the first month of that particular session. The session dates are outlined below:

The following electronic forms of payment are accepted:

* Cash App ($TrinityPrepCenter)
* PayPal (use trinityprepcenter@gmail.com)
* Credit card over the phone (with a 4% processing fee)

After completing the registration form, please send the $25 fee electronically to complete your registration or call 269-430-3171 (include area code when dialing) to arrange payment. Once payment is received, you can expect to attend the next scheduled class time for your registered class(es).

NOTE: Classes begin October 4, 2020. Fees cannot be prorated and are non-refundable.
Email address *
STUDENT FIRST NAME: *
STUDENT LAST NAME: *
STUDENT AGE: *
STUDENT DATE OF BIRTH *
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DD
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STUDENT ADDRESS: *
Please list full address with Street Address, City, State, and Zip Code.
STUDENT CELL PHONE *
Please add the student's cell number if they have their own phone in the event the instructor needs to make contact with them directly. Please remember to include the area code.
DO YOU HAVE ANY PRE-EXISTING HEALTH CONDITIONS? *
Please choose yes if you have asthma, allergies, seizures or any other health condition that may impact your ability to participate to any extent. Note that pre-existing health conditions may not necessarily prevent you from participating; however, it may warrant further conversation or a medical release to participate.
IF YES, PLEASE LIST BELOW:
I AM REGISTERING FOR THE FOLLOWING SESSION
Please note that the Young Adult Hip Hop Experience meets every OTHER Sunday. Class time is from 5pm - 6pm. Exception: There are some classes that will be 5pm - 7pm and May classes will be weekly.You will be notified when those classes are extended. Remember that your FIRST payment is the $25 fee that will go towards your session tuition as outlined below. It is due once you submit this form.

Session 1: $125
Session 2: $125
Session 3: $75

To prevent the spread of germs, especially COVID-19, all participants must wear masks, get temperature taken, and use sanitizer. Additional CDC guidelines and governor's executive orders will be followed as well.  
Young Adult Hip Hop Dance Experience Sessions (Check all that apply.) *
Required
EMERGENCY CONTACT NAME & NUMBER (include full name and number with area code): *
Please list the name and number of someone other than yourself.
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