Cape Cod Hip Hop & Jazz

I am interested in session(s) Session 1 Tuesdays from 4:00 to 5:00 PM July 7 through August 11     Ages 6 - 9     Session 2 Thurdays from 4:00 to 5:00 PM July 9 through August 13     Ages 10 - 17

[ ] Check     [ ] Cash [ ] Visa     [ ] Mastercard [ ] $120.00 Per student per 6 week session

_____________________________________________________ Name                                                                   Birthdate (mm/dd/yy)       Age _____________________________________________________ Name                                                                   Birthdate (mm/dd/yy)       Age _____________________________________________________ Address _____________________________________________________ _____________________________________________________ Phone                                                                   Cell Phone _____________________________________________________ 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.