AOD Fall Registration
2022-2023: Season 3
All Out Dance reserves the right to change or adjust schedule based on availability, scheduling, class enrollment, etc.
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Email *
Student Name *
Parent Name *
Student's Birthday *
MM
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DD
/
YYYY
Student Age *
Address (Street, City, State, Zip) *
Phone Number *
Emergency Contact Name *
Emergency Contact Number *
Emergency Contact Relationship to Student *
Allergies *
Classes ( Check all that apply) *
Required
Photo Release Form for 2022-2023.                          During the year, your child’s image/photograph may be included in studio advertisements, social media posts or publications. Your child’s first name may be included with your child’s picture when put on the web. If you do not wish for your child’s photo to be included in these publications, please note below. Sign the release form below and return this sheet to the office. *
Preferred Payment: Once form is reviewed we will contact you for payment. *
Automatic Payment Plan: You authorize regularly scheduled charges to your credit or debit card. You will be charged the amount indicated below each billing period. A receipt for each payment will be provided to you on your account and the charge will appear on your credit or debit card statement. You agree that no prior-notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 2 days prior to the payment being collected.
Please fill out the following credit card information if you are enrolling in our Automatic Payment Plan  Credit Card Information: Name on Card
Credit Card Information: Card Number
Credit Card Information: Expiration Date
Credit Card Information: CVV Code
Billing Address + Zip Code
How did you hear about us? *
I HAVE READ AND AGREE UPON ALL THE TERMS IN THE AOD FALL 2022-2023 PARENT HANDBOOK & CALENDAR. Please email us for a copy, or come into the studio for a hard copy. After receiving your forms we will contact you with your final registration fee for payment. *
A copy of your responses will be emailed to the address you provided.
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