AYD Withdrawal Form

Could you please take a few moments to fill out the below withdrawal form.

Please note: For AYD Company withdrawals one terms notice is required and any outstanding fees will be requested.

Thank you.

If you require a different format, additional support or have any questions please contact Esme by emailing ebenjamin@artistryyouthdance.com

Young Persons Information

First Name

Last Name

Email

Parent/Caregiver Information

First Name

Last Name

Email

Phone

(###)

###

####

Withdrawal Request Date

MM

DD

YYYY

Last Date of Attendance

MM

DD

YYYY

Reasons for withdrawal

Please provide any additional comments or feedback about your experience with Artistry Youth Dance. Your input is valuable to us and can help us improve our services for other young people.