STORE YOUR INFORMATION⚠️ Make sure to check all information before submitting this form! YOUR CONTACT INFORMATION FIRST Name * LAST Name * Email * Phone Number * (###) ### #### SIGN-UP INFORMATION Are you signing up as a LEAD or FOLLOW? * LEAD FOLLOW Did you get evaluated? * YES NO - I want to sign up as a Beginner TUITON PAYMENT FREQUENCY Please choose a frequency for your tuition payments: * Tuition can be paid Monthly OR In-Full (every 4 months with a $20 discount included) MONTHLY - $140 per month IN FULL - $540 every 4 months ($20 discount included) MEMBERSHIP ADD-ON Minimum Level Requirement: Advanced Beginner Would you like to register for the Ladies Styling & Body Movement class? * YES NO CARD INFORMATION Cardholder Name * Card Number * Expiration * CVV * Zip Code * * I fully authorize Tropik Vybe Dance Company to store and charge my credit/debit card above for tuition and all agreed upon purchases. I understand that my information will be saved for future transactions on my account. VIRTUAL SIGNATURE *
