2019 - 2020 Tumbling Registration Form
Questions marked by * are required.
IMPORTANT: Please be careful to answer all questions marked by *. If any are missed the form will not process and you will be asked to arrow back and fix it. *
If you are registering multiple children; please list youngest to oldest separated by commas: *
Child's Name (First, Last): *
Child's Date of Birth: (MM/DD/YY):
Child's Currrent Age: *
Guardian #1 Name (First, Last) and Cell Phone Number: *
Guardian #2 Name (First, Last) and Cell Phone Number
Student Address Information: (street address) *
Zip Code *
Preferred Phone Number *
Alternate Phone Number (required) *
Primary Email *
Please choose your classes: *
Tumbling I (ages 4-7) Tuesday/11:00am-12:00pm
Tumbling I (ages 4-7) Friday/4:00-5:00pm
Tumbling II (ages 8-11) Friday/5:00-6:00pm
If registering more than one child, and it is not obvious please use this box to clarify which class is for which child.
If there are any medical conditions or special needs for your child please indicate them here:
Tuition payments are due the 1st of the month and considered late after the 7th day of the month. All accounts must have a credit card on file which will automatically be charged along with a $15 late fee if payment is not received by the 8th day of the month. *
The annual registration fee along with your first month's tuition payment must be paid at the time of registration. Please choose your registration amount: *
The tumbling season ends at the end of April. Please choose your tuition option: (if you need help calculating your tuition please call us) - 239-261-2606. *
Option 1: Pay registration fee and full annual tuition at the time of registration, receive a 10% discount on total tuition.
Option 2: Pay tuition in 2 payments, (The 1st payment and registration fee are due at the time of registration, 2nd payment is due by 12/15) - receive a 5% discount on total tuition.
Option 3: Pay tuition monthly. The 1st month’s payment and registration fee is due at the time of registration.
If you do not have a credit card please indicate here:
I do not have a credit card to put on file
Please enter your payment option: (a place in class is not held until payment is made) *
I am providing my card information please process my payment according to the option I have chosen in #21
I will phone in my payment
I will come in and pay in person
Card Expiration Date (mm/yy):
CVV CODE: (3 or 4 digit code on the back of your card)
Billing Zip Code:
If you wish you may sign up for auto-pay. Your monthly payment (if you have chosen option 3) will be processed automatically using the card you provided. Auto pay ensures that your payment will always be on time and you will never have to worry about a late fee! Please indicate your preference
I wish to sign up for monthly auto-pay. I authorize Ave Maria Dance Academy to charge my credit/debit card on the 1st of every month for tumbling tuition ($65)
I do not wish to sign up for auto pay
Don't leave yet! When you click submit you will be directed to the liability waiver (which may take a moment to load) *