Enrollment

Enrollment Form

Please fill out the following fields to enroll your child in JitterBugs. All fields are mandatory.

Phone number:
Last Name:
First Name:
Birthdate:
Gender:
Address:
City:
State:
Zip Code:
School Name:
Teacher/Classroom:
Email of parent or registrant:

Payment Policy

Thank you for your child's participation in the JitterBugs program!

To ensure prompt and accurate crediting to your account, please follow the guidelines below:

For your convenience, JitterBugs encourages the use of auto-draft monthly payments.
Put checks or money orders in the JitterBugs tuition box that is provided.
Please do not give payments to center teachers or directors. Our policy is to cause absolutely no extra work for these busy people!
Include your child's name on the memo line. This is especially important if the student's last name is different from the check writer's last name.
Tuition is an affordable $30.00 per month.

Thanks so much for your cooperation! Have a great day!