Dance & Movement Class for Kids - Request to Register This form is to request registration for your child in the upcoming Dance & Movement Class for Kids. Registration requests may be denied if your registration was received after all available spots have been filled, or after the registration cut-off date. In this case your credit card will not be charged and you will be contacted. If your child has successfully been registered for the class, you will receive booking confirmation emails, as well as an emailed intake form and receipt of your payment.Please allow 1-2 business days for your request to be processed.This class is to be held in Community Room 2 at Reach. (5050 47th Ave. Ladner)How many children will you be registering?*If registering over four participants, please call 604-283-7827 ext.0 to register.OneTwoThreeFourParticipant #1Participant #1 Name* First Last Participant #1 Age*345678Ages 3-5This child will be registered for the 3:30-4:20PM class.Ages 6-8This child will be registered for the 4:30-5:20 PM class.Participant #2Participant #2 Name* First Last Participant #2 Age*345678Ages 3-5This child will be registered for the 3:30-4:20PM class.Ages 6-8This child will be registered for the 4:30-5:20 PM class.Participant #3Participant #3 Name* First Last Participant #3 Age*345678Ages 3-5This child will be registered for the 3:30-4:20PM class.Ages 6-8This child will be registered for the 4:30-5:20 PM class.Participant #4Participant #4 Name* First Last Participant #4 Age*345678Ages 3-5This child will be registered for the 3:30-4:20PM class.Ages 6-8This child will be registered for the 4:30-5:20 PM class.Contact InformationFor parents or guardians.Name of Primary Contact* First Last Cell Phone of Primary Contact*Email of Primary Contact* Name of Secondary Contact* First Last Cell Phone of Secondary Contact*Cancellation/Refund Policy*Refunds will only be given up to 2 weeks prior to the start of the program. After this period, no refunds will be given. This group program is offered as a whole. Refunds or rescheduling will not be available for missed classes. I agree to the cancellation/refund policy.Credit Card InformationIf your registration request is accepted, your card will be charged a one-time fee for this registration. You will be emailed a payment receipt.If spots are no longer available your card will not be charged, and you will be contacted.Name of Cardholder*Account Type*VISAMastercardAMEXAccount Number*Expiration Date*Please enter in "01" for the expiration day. 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I authorize Alongside You to charge my account for services rendered. I certify that I am an authorized user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form.Signature*CAPTCHA