MT ZION PERFORMING ARTS PAYMENT FORM

Billing Name *

First

Last

Email *

A receipt confirmation will be eMailed to you upon completion.

Phone *

Billing Address *

Address Line 1

City

State

Zip Code

Are you paying for Summer or Fall Classes (choose one)? *

Summer Classes
Fall Classes

Enter Amount to be Charged *

Visa or MasterCard Information *

Card Number

Expiration

Security Code

To record your payment properly, please provide your Family ID (found on your invoice) or your Child's First and Last Name. *

I understand that I am paying for classes being offerred by Mt Zion Performing Arts and are subject to the organization's procedures and policies. I have read and agree to the refund and cancellation policies as published in the Mt Zion Performing Arts Registration Booklet or listed on their website for the current season. *

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