Make Payments

MISC PAYMENTS

Name*
What Fee or Item are you paying for?*
Misc Payment Amount*
This field is hidden when viewing the form
Tax
$0.00
Phone Number*
Please enter your phone number for if we have questions about the payment.
Your Email To Send Confirmation*

Please enter your email so that we can send you a confirmation of payment.
Student 1 Name*
First Last
Please type student's name so we can properly process payment to your account.
Payment Method*
- Credit Card
- eCheck - ACH
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck - ACH
Name on Account Bank Name Routing Number Account Number Account Type
Total
$0.00
Taxes and Fees Included

PRIVATE LESSONS

Length of Lesson*
- 15 Minutes ($25)
- 30 Minutes ($40)
- 45 Minutes ($55)
- 60 Minutes ($70)
Date of Lesson
MM slash DD slash YYYY
Name of Instructor
This field is hidden when viewing the form
Tax
$0.00
Total
$0.00
Includes tax
Name of Parent*
First Last
Contact Phone*
Name of Student*
First Last
Contact Email*

Please enter your email so that we can send you a confirmation of receipt of payment
Payment Method*
- Credit Card
- eCheck - ACH
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck - ACH
Name on Account Bank Name Routing Number Account Number Account Type
CAPTCHA

SOLO/DUET/TRIO PUNCHCARD

Package*
- Solo 10 lesson package- $150 (15 min slots)
- Solo 10 lesson package- $300 (30 min slots)
- Duet/Trio 10 lesson package- $100 (15 min slot per dancer)
- Duet/Trio 10 lesson package- $175 (30 min slot per dancer)
This field is hidden when viewing the form
Tax
$0.00
Total
$0.00
Includes tax
Name of Parent*
First Last
Contact Phone*
Name of Student*
First Last
Name of Student
First Last
Name of Student
First Last
Contact Email*

Please enter your email so that we can send you a confirmation of receipt of payment
Payment Method*
- Credit Card
- eCheck - ACH
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck - ACH
Name on Account Bank Name Routing Number Account Number Account Type
CAPTCHA

BIRTHDAY PARTY (Deposit)

Birthday Party Deposit*
Price:
*Non-Refundable payment of $100.00 deposit
Total
$0.00
Name Party was Booked Under*
First Last
Contact Phone*
Contact Email*

Please enter your email so that we can send you a confirmation of receipt of deposit
Payment Method*
- Credit Card
- eCheck - ACH
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck - ACH
Name on Account Bank Name Routing Number Account Number Account Type
CAPTCHA

BIRTHDAY PARTY (Balance)

Number of Guests*
- Up to 15 guests
Add additional guests - $10 each
Total
$0.00
Name Party was Booked Under*
First Last
Contact Phone*
Contact Email*

Please enter your email so that we can send you a confirmation of receipt of payment
Payment Method*
- Credit Card
- eCheck - ACH
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
eCheck - ACH
Name on Account Bank Name Routing Number Account Number Account Type
CAPTCHA

TYPE OF PAYMENT