2025-2026 Season

Withdrawal Notice

Use this form to officially notify MSDA that you wish to withdraw from the studio. Please review the withdrawal policy and complete all required fields. Costumes for withdrawn dancers must be picked up in the office between April 12- April 17, 2027. After these dates, any left over costumes will be donated to a local charity.

Student Name

Parent/Guardian Name

Phone Number

Email Address

Dancer's Location

Current Class Schedule

List the classes the dancer is currently enrolled in. Add only the classes that apply.

Class 1

Class 2

Class 3

Class 4

Class 5

Reason for Withdrawal

Will the dancer fulfill the 30-day notice period?

YesNo — I understand a final tuition charge may apply

Dancer's Last Day of Class

Parent/Guardian Signature

Date

Withdrawal Notice

Current Class Schedule

Let's Find the Perfect Class

Thanks!

0 Directors

Current Class Schedule

Notice Received