Please enable JavaScript in your browser to complete this form.

If you choose Credit/Debit Card you will be asked for your credit card or debit card information AFTER YOU HAVE SELECTED YOUR CLASSES DURING STEP 3. If you are choosing credit card or debit card, please agree to the BELOW terms and hit the submit button.

Credit Card Authorization - Credit Card Payments

I authorize Dana’s Studio of Dance- Southlake, Keller, or Coppell to perform scheduled or periodic electronic funds transfer debits and/or credits from my account identified below for payments due or when applicable, apply electronic funds transfer credits to the same. I understand the dollar amount can vary depending on services performed. Monthly tuition payments will be transferred on the 1st of every month. Costume fees and recital fees will be processed on the 15th of the month in which they are due. Additional payments (ie private lesson fees etc.) will be transferred at the time the expenses are incurred.


Parent's Name
Student's Name


I agree to the above terms and conditions
Clear Signature

Thank you for your business