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SAMSPRA ACADEMY
Developing Noble Leaders
After school and weekend classes Registration
Student Information
Medical Information
Classes Interested (Select Preferred Class level / timing)
Languages
Instrument
Vocal Lessons
Dance Lessons
Academics
Arts & Crafts
Yoga
Culture
Add additional students
Student 2 Information
Medical Information
Classes Interested
Languages
Instrument
Vocal Lessons
Dance Lessons
Academics
Arts & Crafts
Yoga
Culture
Student 3 Information
Medical Information
Classes Interested
Languages
Instrument
Vocal Lessons
Dance Lessons
Academics
Arts & Crafts
Yoga
Culture
Parent Information (is required for students under 18)
Local Emergency Contact
Fees and Payment
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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 :
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