Register - KONTAGIOUS PERFORMING COMPANY

Class Registration

Contact Information

* Indicates required field

Participant Name *

First

Last

Parent Name (If Applicable) *

Email *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Class Selection

Dance Classes ($50/class) *

Contemporary Ballet Breakdancing Adult Hip Hop (13+)

Payment Information

Name As It Appears On Card *

Name As It Appears On Card *

Billing Zip Code *

Total Amount To be charged *

Expiration Date *

CVV Number (On Back Of Card) *

Any other questions, comments, or concerns? *

Submit