ACADEMY LEVELS 2a & 2b – Sign-up

MSAD-SCB classes run September 8th through June 4th 

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Dancer Name *

First

Last

Gender *

• Female
• Male

List your dancers experience *

Please provide a short list of your or your dancers experience and training

Date of Birth *

Parent / Guardian Name *

First

Last

Address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Phone *

Is your dancer new or reoccurring? *

• New Student Registration $40.00
• Reoccurring Student Registration $35.00

Choose Your Payment Option *

• Monthly Payment $171.00 (10-Payments)
• One Time Payment in Full $1,710.00

Guardian Like Address

How Would You Like to Pay *

• Charge my card on file (returning student)
• Charge card below
• I will pay by check in full on or before the first day of class

Credit Card Number

On-file credit card info.

Expiration Date

CID#

3-digit on the back or 4-digit on the front of skin care card

Zip Code

Terms of Registration – Check All *

• I understand that I must provide my credit card information above and authorize MainStage Academy of Dance to charge my card if I am making payment by credit card.
• I understand I am required to complete and sign an in-studio Registration / Terms Form before classes may begin.
• I agree to all MainStage Academy of Dance–SCB’s Terms and Conditions as outlined.
• I understand my child and I are required to follow MSAD-SCB’s Student Handbook.
• I understand that classes that do not meet minimum enrollment may be cancelled or combined. Tuition credits or refunds will be provided to those already registered.

View Terms & Conditions

Form Security Question *

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