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Motion
Mania Dance Center Registration Form and Agreement
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| Student Name: _________________________________________________ | PH# (H) ___________________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Parent/Guardian: ________________________________________________ | PH# (W) ___________________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Address: _______________________________________________________ | PH# (C) ___________________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| City/State: _______________________________________ | Zip: __________ | Birthdate: ____________ | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Email: ___________________________________________ | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| ENROLLMENT:
All student enrollments are for a minimum of one full semester. The full
tuition is the promised amount of payment to the Motion Mania Dance Center
and is payable in full at the time of enrollment and are not refundable,
except as stated below. Unlimited Cards are good for twelve months and
are payable in four equal installments which are not refundable. The following notification is required by legislation passed by the Montgomery County Council under Bill Number 22-92. Consumer Protection Future Service Contracts, which became effective on November 9, 1993. CANCELLATION AND REFUND: Under Montgomery County law, you can cancel this contract without any obligation within 3 business days after signing it and receive a full refund. You must notify MOTION MANIA DANCE CENTER of your decision to cancel this contract by Certified Mail or by written notice delivered to MONTION MANIA DANCE CENTER at 327 Muddy Branch Rd., Gaithersburg, Montgomery County, MD 20878. OTHER DISCLOSURES: The Federal Truth in Lending Law gives you certain rights to stop any automatic charge against your credit card or bank account under this contract. The only charges or fees you are required to pay under this contract are the TUITION AND REGISTRATION FEES published each semester in the MMDC newsletter and class schedule, which, by reference in hereby made a part of this contract. |
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I have read and
understand the above statements and wish to enroll _______________________________________________
in the MOTION MANIA DANCE CENTER'S dance class(es) listed below |
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| Date: ____________________ | Signed by: ___________________________________________________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| _______ NEW STUDENT _______ RETURNING STUDENT | CLASSES PER WEEK _____________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| TUITION _______________ | P/C ____________ | BEG. DATE _______________ | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Credit Card #: ______________________________________________________ | Exp Date: ______________ | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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