September 7, 2002 - June 5, 2003

(After registering online - please submit payment promptly)

STOP !!! If you are under the age of 13, please obtain permission from your parents prior to completing this form.

Information collected from this form is used solely by Springfield Dance, Inc. to register students for classes and to provide students with further information of other activities pertaining to their participation in Springfield Dance, Inc.

Children's Online Privacy Protection Act of 1998

Please provide the following information (* required):

Fall Tuition

Tuition is determined by adding the number of hours per week your child is taking class and applying it to the chart below. Multiple family members get a $10 discount. Payments are due on the 15th of the preceding month and a $10 late fee will be charged after the 1st of the month, unless prior notification is given to drop a class.

NO REFUNDS OR CREDITS FOR MISSED CLASSES.
Make-up lessons may be arranged by checking the schedule.

Hours / Week	Fee
One Class	$12
45 Minutes	$35
1 Hour	$40
1 Hour 30 Minutes	$45
1 Hour 45 Minutes	$48
2 Hours	$50
2 Hours 30 Minutes	$55
2 Hours 45 Minutes	$58
3 Hours	$60
3 Hours 30 Minutes	$65

Hours / Week	Fee
3 Hours 45 Minutes	$68
4 Hours	$70
4 Hours 30 Minutes	$75
4 Hours 45 Minutes	$78
5 Hours	$80
5 Hours 30 Minutes	$85
5 Hours 45 Minutes	$88
6 Hours	$90
Individual Unlimited	$100
Family Unlimited	$130

A $10 fee will be charged for returned checks, and second offenders must pay cash. Make checks payable to Springfield Dance.