Student Information

Medical Information

Languages

Instrument

Vocal Lessons

Dance Lessons

Academics

Arts & Crafts

Yoga

Culture

Add additional students

Parent Information  (is required for students under 18)

Local Emergency Contact

Fees and Payment

• One time annual non-refundable registration fee of $30 is payable to Samspra Academy at the time of registration.

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• Tuition is due on the 1st day of class payable to Samspra Academy. Late fee of $10 will be applied to payments made after 7th of the month.

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• Both monthly and semester payment options are available. Discount applies to semester pay.

How would you like to pay ?

Above information is correct to my knowledge.

I authorize Samspra Academy to render services / seek medical help to the student. I understand that I am financially responsible for any expenses.

I have read and understood Samspra Academy's Policies and Guidelines and I will abide to it.

I have read and agree to Samspra Academy's Accident Waiver and Release of Liability Form.

Parent's / Guardian's signature :