Withdrawal Request

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Withdrawal Request

Please fill out the following form to complete your student's withdrawal from their dance class(es). If they are in more than one class, please list each class you would like to withdraw from. If you are withdrawing more than one student, please complete a separate submission for each student.

Our business office will process your withdrawal request and send you a confirmation of the processed withdrawal. Please allow at least 72 hours for us to process the request.

Parent/Guardian Name *

Parent/Guardian Email *

Phone Number *

Student's Name *

Student's Class(es) to Withdrawal From *

Student's Teacher Name *

Requested Withdrawal Date *

YYYY

Last Day to Attend Class *

YYYY

Reason for Withdrawal *

Please check the following boxes indicating your knowledge of the following policies:
*

I understand that Foot Works PAC requires written notice to withdraw from a class and that notice must be given by using our online withdrawal request form.

I understand that there are no refunds on any fees previously paid when withdrawing from Foot Works PAC.

I understand that my child's spot in class is no longer held once I withdraw.

I understand that Foot Works PAC requires 30 days notice.

I understand my enrollment will cease 30 days after this notification is given and I am responsible for the monthly membership fee up until that date.

Required

Signature (Type Name) *

Submit

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