(All information below must be provided, including email address)
Date:_________________
Lisa Regina:_____________________________________ (212) 966-2982
Student (please sign): _______________________________________
Age: ______ Email: __________________ (must include email address)
Mailing Address: _______________________________________________________________
Phone: ________________ Cell Phone: ________________
Parent or Guardian __________________________________ (if under 18 years of age)
PLEASE SIGN AND RETURN AGREEMENT WITH PAYMENT BY MAIL.
THANK YOU! I LOOK FORWARD TO WORKING WITH YOU SOON!
The following agreement is between LR Acting Workshops, LLC (Lisa Regina,) acting coach and the student. The cost of this 8-week workshop is five-hundred and fifty dollars ($550) paid in full prior to the FIRST DAY of CLASS (no exceptions). The full amount will be refunded in the event that the workshops are cancelled
DATES: SUNDAYS: Nov. 2, 9, 16, 23, 30 Dec. 7, 14, 21
CLASS TIMES: (Please circle which you will attend)
2:00pm – 3:15pm: Youth Class (7 & up)
3:30pm – 5:30pm: Adult Class (13 & up)
The following payment plan may be applied…
$275.00 deposit due with registration form to reserve space in class (non-refundable)
Balance of $275.00 due 1 week before 1st day of class.
Checks or Money order are made payable to:
Lisa Regina, LR Acting Workshops, LLC
Mail to: Mail to: 154 East 97th Street #16, New York, NY 10029
(Any fees associated with returned checks will be the sole responsibility of the student.)
Winter Class, 8 week Term
Variations –A Dancer’s Studio
180 Spring Rd
Huntington Village, NY 11743