Toni Schwartz Studio of Dance

CREDIT CARD

INFORMATION

QUICK REGISTRATION:

Email me at Toni@TonisDanceWebsite.com

-Send Dancers Name and Age

-Class Selection (Day and Time)

-Parents name/phone number.

Then simply scan over the completed Registration and Card forms found on this website.

Use PayPal for your convenience.

​Text me at 215-547-7989

Families have the option to pay one time or for the entire season (Monthly) by Credit/Debit.  Please note a fee of 2.75% is added.  Please print out, complete and send along with the registration form.


______VISA    _______MASTER CARD    _______DISCOVER     _______AMERICAN EXPRESS    

______CREDIT CARD     ______DEBIT CARD


STUDENT NAME:____________________________________________________________________________________________


Card Number:_______________________________________________________________________________________________


Expiration Date:  _____/_____        3-4 Digit Security Code on back:  _______          Billing Zip Code:  _______________


Name as it appears on card:  _________________________________________________________________________________


Cell Phone Number for Text Receipt:  __________________________________________________________________________


_____AUTO-PAY.  I would like my credit card automatically charged on the first of the month.  I am aware a fee of approximately 2.75% will be applied.


_____RECITAL COSTUME:  I would like my credit card automatically charged on 11/7/15 for the recital costume(s).  I am aware a fee of approximately 2.75% will be applied.


_____TODAY ONLY:  I would like to register my student for dance classes.  Please charge my card ONE TIME for the first month of tuition and registration fee, ONLY.  I am aware a fee of approximately 2.75% will be applied.


_____COMPETITION ENTRY FEES:  I would like Competition Entry Fees automatically charged on their due date.  I am aware of fee of approximately 2.75% will be applied.


I hereby authorize Toni Schwartz Studio of Dance to charge the above credit card as checked.   I understand there are NO REFUNDS.


X__________________________

      Purchaser's Signature