The Place for Dance Class Registration Form PAYMENT MADE BY CREDIT CARD: You can now pay for classes with a credit card using paypal. You do NOT need a paypal account. Simply click HERE to go to the credit card page. There is a fee for processing credit card payments.
PAYMENT MADE BY CHECK: Please print out and mail this form and payment to: The Place for Dance at Sylvania Academy of Dance c/o Kay 6600 Sylvania Avenue, Sylvania, OH 43560. PLEASE MAKE ALL CHECKS PAYABLE TO: KayLouise Please note: A place in any class is not secured without receipt of the registration form and class fees. Should a class be full when your form/fee is received, you will be placed on a waiting list and notified of the next available class time. Name of the class you are registering for: Class Day: Time and Location: Date Class Begins: Your Name: Mailing Address: Home Phone: Work Phone: Cell Phone: Email Address: Please list any physical restrictions, recent surgeries or medical conditions: KayLouise, The Place for Dance, Bedford Dance Academy, Sylvania Academy of Dance and staff will not assume liabilty or responsibility for the loss of property or injury incurred by you or others while participating in this class. We recommend students notify their physician before beginning any physical and/or fitness program. By agreeing to participate, you assume the risk and responsibility for injuries and/or loss. Signature:_______________________________________________________________ Emergency Contact and Phone Number:___________________________________________ Please phone KayLouise at The Place if you have any questions: 419-280-3674, theplacetoledo@yahoo.com Class fees are non-refundable. Should you be unable to attend the session, a class or merchandise credit will be given if we are notified BEFORE the session begins. After a session begins, class credits will not be offered.