Fill out and print this form, sign waiver, and fax or mail to address at bottom.
Title:
First Name:
Last Name:
Street Address:
City:
State:
Postal Code:
Country:
E-Mail Address:
Daytime Phone:
Mobile:
Home Phone:
Dance Studio:
Teacher Name:
How Did You Hear About Us?
Please Specify:
For Children & Teens under 18:
Birth Date:
Age:
School Name:
Grade:
Parent/Guardian Name:
Billing Address (if different):
Billing Name:
Street Address:
City, State:
Postal Code:
Phone:
Email:
Class Choice: Write in class selection with level, day & time.
Youth Program:
Tap City
Youth Ensemble:
Adult Program:
Tuition & Fees: W rite in your tuition amount and total. See the website for tuition for the program you are selecting, or speak to the Registrar. Include Youth Concert Fee (for Youth Program) or TCYE Costume Fee (for TCYE), and include Registration Fee.
1. Youth Tuition: $
2. Youth/Concert Fee: $75
3. TCYE Tuition:
4. TCYE Materials Fee: $75
5. Adult Tuition:
Non-Refundable Registration Fee: $35
Family Reg Fee: $40
Total = $
Payment Options:
Full Amount is enclosed!
I would like the 3-Installment Payment Plan (Registrar will send a payment plan agreement and invoice. (For Youth & TCYE only)
I am applying for a scholarship
(For Youth & TCYE only)
Credit Card: (Mail or Fax)
Card Type:
Card #:
Exp. Date:
Name on card:
Check or Money Order: ($US)
Make check payable to: American Tap Dance Foundation (ATDF) and mail it with this form to the address below.
Waiver: I (parents please sign for students under 18) hereby release the ATDF, instuctors, sponsors and all event locations from any and all claims or liability due to personal injury, loss or damage of property which I (or my child) may sustain as a result of participating in any activity connected with the ATDF.
______________________________________________ Signature and Date
.
Send to: American Tap Dance Foundation, 18 West 27th Street (6th Floor), New York, NY 10001 Phone (646) 230-9564, Fax (646) 230-7777
Confirmation Notice: You will receive a confirmation notice by E-Mail. Click if you would prefer to receive hard copy via regular mail.
Please contact us if you don't receive your confirmation within two weeks.
Tap City features
eight action packed days of programs and events where hundreds of
tap dancers converge on the tap dance capital of the world to study,
perform, teach, observe, share and dance!
Master Tap Intensives give advanced students a chance to work with a top teacher and choreographer in the field. Students experience first hand the choreographic process and creation of original material that will be presented in future productions produced by the ATDF.
