Student's Name:

Date of birth:                       Age:  

Parent's Name:

   Street:
    City:  
   State:      Zip: 

Phone:

Email:

Emergency contact: 
 (name & phone )
 

Tuition Policy 

All payments on monthly tuition are due the first week of class every month. Any tuition received after the first week will be charged a $5.00 late fee.

 All payments on the Open classes are due on a weekly basis. 

I have read and agree to the above Policy: Please type your name in the box.

Student signature:

Parent signature  (if student is under 18):