Just Dance LLC Registration

Dance Class Option

Parent Contact Information

Parent First Name

Parent Last Name

Email Address

Phone Number

Student Full Name

Student Age

School

**Please be able to write the correct school name and location.

I have read and agree to the to the Liability WaiverTuition & Policies

Service Provided:

Preschoolers, Tap & Ballet-- $65.00 [Monthly Tuition] + $30.00 [Yearly Reg.Fee]=$95

Signature

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