Automatic Payment Form: 
If you would like to enjoy the convenience of monthly automatic payments, simply complete the form below. You may cancel this payment option at any time. Just let us know when, and we'll do the rest. Thanks ! 

INTUIT is our safe and secure automatic payment provider. Over 1,100 of our enrolled families use this service monthly and are loving the ease and convenience !  :) Your completed information is sent directly to Lynn Hunter, the owner of KidzDance. No information is available to our instructors. 

All requested information is required.

Parent name: 
Childs name: 
Center name and location: 
Email address: 
Recurring amount: 
Payment start date: 
Card type: (Visa, MasterCard, etc.)
Name as shown on card: 
Card number: 
Expiration date: 
Zip code: 
Parent signature: