Parent's Name *

First Name

Last Name

Phone *

(###)

###

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Child's Birthday *

MM

DD

YYYY

Workshop of Interest

Saturdays (July 15, 22, 29)

9:30-10:45am : Samba Reggae (for ages 4-6): $75

11-12:30pm : Light (for ages 5-8): $90

Sundays (July 16, 23, 30)

10-10:45am : Creative Movement (for ages 2-3.5): $55

Help us keep 100% of your contribution when paying by CC *

Yes, I want to cover the small processing fees for IMA

No, I don't want to cover the processing fees for IMA

Acknowledgment *

A minimum of 6 children must register in order to run a workshop. If the workshop is canceled by IMA because of low enrollment or otherwise, all payments including the deposit will be refunded.

I, the parent or guardian, acknowledge that the remainder of the workshop cost (total minus $15 deposit) is not refundable once the workshop has started. The remainder is 25% refundable up to one week prior, 50% refundable 2 weeks prior, and 100% refundable anytime before that.