|We also offer the option to mail in your registration. Please complete the form below and mail to:|
Letís Dance Studio
@ The Academy of Performing Arts
111 East High Street
Glassboro, NJ 08028
Let’s Dance Studio
STATE________ZIP CODE_____________EMAIL ADDRESS__________________________________
PHONE #___________________EMERGENCY NAME & #____________________________________
HEALTH CONDITIONS/FOOD ALERGIES__________________________________________________
PREVIOUS DANCE TRAINING______________________PARENTS NAME________________________
HOW DID YOU HEAR ABOUT US?______________________________________________________
TYPE OF CLASS DESIRED ____________________________________________________________
CLASS DAY & TIME_________________________________________________ (OFFICE USE ONLY)
REGISTRATION FEE: $25.00 DUE UPON REGISTRATION - NON REFUNDABLE
CXS CS CM CL AS AM AL AXL
PLEASE READ AND SIGN BELOW
1. MY CHILD'S MONTHLY TUITION IS _________. I AM AWARE THAT THIS IS DUE THE FIRST CLASS OF EACH MONTH. IF IT IS NOT PAID BY THE 15TH OF EACH MONTH, I WILL PAY A LATE FEE OF $12.00. IF TUITION IS NOT PAID BY THE 30TH, FURTHER COLLECTION ACTION MAY BE TAKEN AND YOUR CHILD MAY BE ASKED TO WITHDRAW FROM DANCE CLASSES.
2. I AM AWARE THAT TUITION PAID FROM SEPTEMBER THROUGH JUNE INCLUDES THE JUNE RECITAL COSTUME AND 2 PARENT TICKETS TO THE CHRISTMAS SHOW AND THE JUNE RECITAL. IF MY CHILD WITHDRAWS AFTER JANUARY 1ST I WILL BE RESPONSIBLE FOR THE REMAINING COSTUME BALANCE. $12.00 OUT OF EVERY MONTHLY TUITION PAYMENT IS SET ASIDE FOR COSTUME AND TICKET COSTS.
3. IF MY CHILD STARTS AFTER SEPTEMBER I WILL BE RESPONSIBLE FOR THE COSTUME BALANCE WHICH IS $12.00 PER MONTH.
4. IF ANY CLASSES ARE MISSED, THEY CAN BE MADE UP AT ANOTHER SCHEDULED TIME. NO REFUNDS OR CREDITS WILL BE ISSUED.
5. I AM AWARE THAT MONTHLY TUITION INCLUDES TWO COMPLIMENTARY PARENT TICKETS FOR THE RECITAL. IF MY CHILD TAKES MORE THAN ONE CLASS AND PERFORMS ON DIFERENT NIGHTS, OR IF I HAVE MORE THAN ONE CHILD DANCING, A TOTAL OF TWO TICKETS PER FAMILY STILL APPLIES. THESE TICKETS MAY BE USED FOR ANY PERFORMANCE.
6. I REALIZE VIDEOS AND PHOTOS MAY BE TAKEN AND USED FOR ADVERTISING FOR THE STUDIO.
I HAVE READ THE ABOVE TERMS AND AGREE TO THE TERMS STATED.
Let’s Dance Studio
I understand that dance and tumbling activities as conducted and taught at the studio have inherent risks of injury. These risks include muscle pain, pulls, broken bones, ankle injuries and other personal injury. I recognize the student is exposing herself/himself to such risks when undertaking dance and tumbling activities. I understand that these risks cannot be fully eliminated without jeopardizing the essential qualities of the activity. The student and I assume and accept all risks of injury or damage resulting in such dance and tumbling activities. The student’s participation in this activity is purely voluntary, and the student elects to participate, and I join in that election, in spite of the risks.
I further understand that I’ve been advised of the need for the student to be covered by adequate insurance to cover any injury or damage that may be suffered while participating, and I have obtained such insurance or I agree to bear the cost of any such injury or damage myself.
By signing and dating this Release, I confirm that I have read the Release in full, that I understand its terms, and that I agree with those terms.
I, ________________________________________ (parent/guardian’s name) hereby give permission for any and all medical attention to be administered to my child _____________________________________________ (child’s name) in the event of accident, injury, sickness, etc., under the direction of the physician(s) listed below or at any necessary emergency facility, until such time as I may be contacted. I also assume the responsibility for the payment of any such treatment. This release is effective for the period of one year from the date given below.
INSURANCE COMPANY: _____________________________________________________________
POLICY NUMBER: _________________________________________________________________
CHILD’S PHYSICIAN: _______________________________________________________________
PHYSICIAN PHONE: ________________________________________________________________
SIGNATURE (PARENT/GUARDIAN): ____________________________________________________