Company Information
Please complete and submit this form for each student you wish to register.
You will receive a confirmation email for your requested classes.
You will be notified within 7 days if a class you requested is full.
Parent(s)/Guardian(s) Name:
Billing Address:
Suite or Apt #:
City, St, Zip:
Email:
Home Phone:
Cell/Work Phone:
Student 1 Name:
Student 1 Date of Birth:
Student 1 Class Choices:
Class Name
Day
Time
Location
1.
2.
3.
4.
5.
Student 2 Name:
Student 2 Date of Birth:
Student 2 Class Choices:
Student 3 Name:
Student 3 Date of Birth:
Student 3 Class Choices:
Will you pay the $30.00 Registration Fee using our online payment service?
Yes, I will pay online immediately after submitting this form so I can be registered as soon as possible. No, I prefer to mail my $30 Registration Fee to: Dance Creations, 11182 Avery Row, Fishers, IN 46038.
Preferred Payment Method
By Month (auto pay from checking account - please mail in EFT form with voided check) By semester (check or credit card)
I give Dance Creations permission to use my bank account & voided check provided in 2009-10 for EFT withdrawals for the 2010-11 dance season.
Click here to download EFT form.
(See form for monthly prices)
Comments or questions:
How did you hear about us?:
As with any physical activity there is a risk of injury. I agree that I will not hold Dance Creations, LLC, East 91st Street Church, or any Faculty or Instructor responsible for any injury to my child or children.
By submitting this form, you are stating that you understand and agree with the above disclaimer.
Dance Creations, LLC 317-579-0117 Serving Fishers/Castleton/Geist Company Information
