Enrollment Forms

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Auto-Charge Enrollment Form

Number of Students*
Student Name
First Last
Student 2 Name
First Last
Student 3 Name
First Last
Name
First Last
Email
Billing Address*
Street Address Address Line 2 City State ZIP Code
Credit Card Number*
Expiration Date (MMYY)*
CVV Number*
Please enter a number from 0 to 9999.
I hereby authorize Miss Maria's Dance, Cheer, Gymnastics to charge my card on the first of each month for the following charges along with a 3% service fee.*
- Monthly Tuition, Costume Fees (Due In December), and Recital Fees (Due In April)

Auto Draft Enrollment Form

Number of Students*
Student Name
First Last
Student 2 Name
First Last
Student 3 Name
First Last
Name
First Last
Email
Billing Address*
Street Address Address Line 2 City State ZIP Code
Bank Name*
Bank Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Type of Account*
- Checking
- Savings
Check Routing Number*
See picture below for reference.
Check Account Number*
See picture below for reference.
I agree to have the following fees deducted from my account.*
- Monthly Tuition, Costume Fees (With December Tuition), and Recital Fees (With April Tuition)
I hereby authorize Miss Maria's Dance, Cheer, Gymnastics, hereinafter called COMPANY, to initiate debit entries to my account indicated above and the financial institution named below, hereinafter called DEPOSITORY. This authorizationis to remain in full force and effect until COMPANY has received written notification from me (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.*
- I agree
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Printable Enrollment Form

Private Lesson Contract

If your child would like to have additional one on one assistance private lessons can be arranged. This contract is an overview of cost for students and non-students. If you do not currently have a teacher that can conduct lessons with your child please contact the office and they will pair you up with a teacher that will fill the required dance/tumble/cheer needs of your child.

Download Private Lesson Contract

Miss Maria's Students - Sign Up For a Private Lesson Here!

Non-Miss Maria's Students - Sign Up For a Private Lesson Here!

Hold Harmless Agreement

The undersigned, in consideration of participation in this program, agrees to indemnify, defend, hold harmless and release Miss Maria’s Dance, Cheer & Gymnastics, Inc., its officers, directors, instructors, employees and/or assigns, from any and all direct or indirect liabilities, injuries and/or death, costs, damages and reasonable attorneys’ fees, which may be suffered by the below named individual registered in this program arising out of or in any way connected with participation in the program including parties and special events.

Class/Event Attending?*
If attending a birthday party, please put the name of the birthday girl/boy.
Date of Event*
MM slash DD slash YYYY
Name of individual participating in class or event*
First Last
Name of additional individuals participating in class or event
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Email*
Phone Number*
Parent or guardian name*
First Last
Date*
MM slash DD slash YYYY

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