Fill in the following information to have your credit or debit card automatically charged your account balance each month.
As registered online in your Jackrabbit account
Helps us credit your account if your dancer's name is different from the person paying, or the family account name.
Name as on Card
Enter in MM/YR format.
Security Code Number
Please enter the 3-digit security code found on the backside of your card.
Billing address with zip code
Your payment info will be processed as directed.
Expect your account balance to be charged in full during the time period of the 1st-5th of every month. This form is accessible for you to edit or resubmit at any time. If you have any questions or would like to discuss AutoPay or your SBDA account, please contact SBDA Bookkeeper Alisa Vass at
Send me a copy of my responses.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service