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Student First Name (required!)
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Student Last Name (required!)
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Female
Male
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Medical Considerations (required!)
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Name of Student's Teacher at Calvary Christian Academy: (required!)
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Enter below the class your child will be taking:
Tuesday 9:15-10:00 Ages (3-4) Pre Ballet/Tap
Friday: 4:15-5:00 - Ages (5-6) Pre Ballet/Tap
Friday: 5:15-6:00 - Ages (7 and up) Ballet/Tap. These Students will need to be picked up in the Cafeteria after class (required!)
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Monthly Tuition (required!)
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$50
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Contact Name: (required!)
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Email Address: (required!)
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TYPE OF PAYMENT (required!)
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(required!)
Consent and Release: As student/ legal guardian of student named above, I give my permission for his/her involvement in activities, performances including off campus events of Dance Academy of Mansfield. Parents, legal guardians of minors, students and adult students waive the right to any legal action for any injury sustained on school property resulting from dance activity or any other activity conducted by students before, during, or after class time. I consent to the use of any video images, photography, and audio recording, or any visual or audio reproduction that may be taken of the student during any class or event.
I herby authorize Dance Academy of Mansfield to initiate recurring debit entries to my bank Account at the depository institution named and in the amount(s) and on the dates or days indicated.
*A $10 fee will be charged for ALL declined debit, credit, and automatic bank draft transactions. This includes expired expiration dates on credit cards.*
This is a confidential agreement between you and Dance Academy of Mansfield and will be secure. Your Monthly payment for tuition will on the first of every month.
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