Cape Cod Hip Hop

Cape Cod Hip Hop & Jazz

Summer 2017 Dance Registration Form
I am interested in session(s) $ check mark
Session 1 - July 10 through July 14
    Ages 4 - 7     9:00 AM to 11:00 AM
$200.00    
Session 2 - July 10 through July 14
    Ages 9 - 16     4:00 PM to 6:00 PM
$200.00    
Session 3 - July 17 through July 21
    Ages 6 - 10     9:00 AM to 11:00 AM
$200.00    
Session 4 - 2 Wk Intensive Training**
        July 17 - July 21 & July 24 - July 28
    Ages 10 - 18     3:00 PM to 6:00 PM
$600.00    
Session 5 - July 31 through Aug 4
    Ages 12 - 18     4:00 PM to 6:00 PM
$200.00    
[ ] Visa     [ ] Mastercard [ ] Check     [ ] Cash
________ - ________ - ________ - ________ Exp: ____/____ (MM/YY)

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Name                                                                   Birthdate (mm/dd/yy)       Age
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Address
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City                                                                                             State                               Zip
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Phone                                                                    Cell Phone
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Parent Signature

Rates & Schedules are subject to change.
There will be no refunds on cancellations. Once a student enrolls they are taking the place of another
potential student. Enrollment fee will only be returned for medical reasons or injury with a doctor's letter.
Please print and mail registration with payment to:
Cape Cod Hip Hop & Jazz
87A Enterprise Road
Hyannis, MA 02601

Make Checks Payable to Atlantic Coast Academy of Dance