2019-20 Dance Season Registration

Our Registration fee is $50 per family and is due at the time of online registration.

Parent*

First Name Last Name

Email Address*

Phone*

How many dancers are you registering?*

1
2
3
4

Dancer 1*

First Name Last Name

Date of Birth*

Grade entering this upcoming school year?*

Dancer 1 Class Selection*

Dancer 2*

First Name Last Name

Date of Birth (Dancer 2)*

Grade entering this upcoming school year?*

Dancer 2 Class Selection*

Dancer 3*

First Name Last Name

Date of Birth (Dancer 3)*

Grade entering this upcoming school year?*

Dancer 3 Class Selection*

Dancer 4*

First Name Last Name

Date of Birth (Dancer 4)*

Grade entering this upcoming school year?*

Dancer 4 Class Selection*

Questions or Comments

Registration Fee*

Price: $50.00

Processing Fee

$3.00

Total

$0.00

Credit Card*

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Billing Address*

Street Address Address Line 2 City State ZIP Code

Sherry Martin Dance Terms of Service

By checking the box below, you confirm that you have read and understood all Sherry Martin Dance information, policies, and pricing located on this website (click HERE to read). Students, family and staff assume personal responsibility for participation in our dance program. Photographs may be used for advertising purposes. I understand that Sherry Martin Dance is not responsible for any injuries sustained prior to the beginning of classes. I recognize that my child's participation may expose him or her to the risk of injury or harm. I accept the risk and hereby release Sherry Martin Dance and all employees from all liability from personal injury, illness or property damage incurring during instruction or performance. I certify that my child is in good health and capable of participating in all activities and classes. Sherry Martin Dance is not responsible for any lost, stolen or damaged items. If your account is in arrears more than 30 days, your child's participation will be in jeopardy regarding regularly scheduled dance classes and any performances (including competition).

*

I have read and agreed to the terms above.

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2019-20 Dance Season Registration Form

Sherry Martin Dance Terms of Service

716.626.2498

[email protected]