NJCODistance Learning Registration
Please fill out a separate form for each student. If paying though Venmo, please send payment to @NJCOD
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Email *
Parent First and Last Name *
Phone Number *
Child's Name *
Child's School District *
Child's School *
Child's Grade *
How many days a week will your child be attending?          *To ensure we abide by current healthcare standards (and limit the number of students) we are requiring enrollment in a minimum of two days per week. This will limit the interactions between groups of students. *
What days of the week will your child be attending?                                                                               *
Required
I would like my child to receive Enrichment instruction and activities. I understand this is an additional $30 per day
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Is your child a current student at New Jersey Center of Dance? *
 Important Information You Want Us to Know About Your Child *
I understand and agree that first payment is due upon registration and that  I will be billed 10/7/2020 for Session 2 and 11/4/2020 for Session 3  based on the days I have chosen to enroll. I understand there will be a $35 late fee for late payments *
I have read the program description and agree to abide by all expectations and safety procedures. *
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