2765 South Main Street Unit A      
Kennesaw, Georgia 30144      
770-425-8200
2008 Online Registration
Student Name:
Date of Birth:
Age:
Parent's Names:
Cell Phone Number:
Home Phone Number:
E-mail Address:
Address:
City/State/Zip:
Dance Experience:
CLASS REGISTRATION
1st Choice Class:
Day/Time:
2nd Choice Class:
Day/Time:
Total Hours Weekly:
Monthly Tuition:
Family Discount:
No
Yes
Billing Contact Name:
I understand that tuition is due on the 1st of the month and I will be charged a
late fee after the 1sth of each month.
I understand that I am responsible for tuition until a written withdrawal form is
completed and signed by myself. I must have this completed 15 days before withdrawal.
I understand that there will be no refunds on costume fee after December 1st.  A late fee
of $15 will be charged to costume balances after Jan 1st.
Electronic Signature:
Date: