Company Information
Please complete and submit this form to register up to 3 students.
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 for tuition
Monthly Fee Schedule
By Month (auto pay EFT from checking account) By semester (Check). Multiply monthly rate by 4.5. Semester payments due at enrollment or no later than Sept. 1 & Dec. 15th. You will be invoiced by e-mail.
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
