Hip Hop Master Class Flyer Registration Combo.pub
Transcription
Anthony Lofendo has worked with artists such as Lady GaGa, Will.I.Am, Katy Perry, Jordin Sparks, and many more! He’s been featured in film (This is the End) and television (GLEE). His charismatic personality and extensive knowledge makes him highly sought after in the world of dance. APAC Hip Hop Master Class Registration Form Please fill out the form below and return with full payment to: APAC 1049 Industrial Blvd, Ste 200 Abilene, TX 79602 You will receive an email confirmation once this form and payment are received. One registration form per student please. We accept CASH or CHECK payments. Checks payable to APAC. Please check the appropriate Wednesday, May 20th Hip Hop Master Class: 3rd-5th Grade 4:00-5:30 p.m. 6th & Older 6:00-7:30 p.m. Student Name: ___________________________________ Age: ____ Current Grade: ____ Parent/Guardian Name: ___________________________________ Contact Number: ________________ Parent/Guardian Email Address: _________________________________________________ Student is currently enrolled in an APAC class: __Yes __No If yes, which class? ___________________ Payment Information (Payment is non-refundable): __ 2014-2015 APAC Student Cost - $25 per student __ Non APAC Student Cost - $35 per student __Cash __Check ______Check Number $_______Payment Total I hereby allow APAC to take photographs of my child to be used for public relations and archival purposes. __Yes __No By signing below, I understand that APAC, its staff and Board of Directors are not responsible for accidents that may occur before, during or after this APAC Master Class. I also understand that the payment I have made is NON-REFUNDABLE. Parent/Guardian Signature ________________________________________ Date _____________
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