DIP Dancer Registration Form

DIP DANCER REGISTRATION FORM

2024 - 2025 DANCE SEASON - DIP STUDIOS, LLC - ONLINE REGISTRATION FORM
Dance Institute of Philadelphia Studios
3251 Fox Street, Philadelphia, PA 19129 (Fox St. Studios)
215-416-7368 DIPstudiosLLC@gmail.com www.DIP5900.com
STUDENT INFORMATION

All fees PAID to DIP are Non-Refundable. Payments are DUE AT TIME OF REGISTRATION. Submit this form, then you will be taken to the Payment Portal on our website FOR ONLINE PAYMENT. (Please Note: All future tuition payments are due by the first of the month.)
Dancer's Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Age as of Sept. 1, 2024
Dancer is a:
Parent/Guardian Name

First NameLast Name
Primary Phone/Cell
Main number to be reachedFormat: (000) 000-0000.
Secondary Phone/Cell
Format: (000) 000-0000.
E-mail Address
example@example.com
Mailing Address

Street Address Line 1

Street Address Line 2

CityState

Zip Code
Name of person responsible for paying fees. (Fill in this section ONLY if different then above.)

First NameLast Name
Billing Phone/Cell
Main number to be reachedFormat: (000) 000-0000.
Billing E-mail Address
example@example.com
Classes & Fees 2024-2025

CHOOSE YOUR DANCE CLASS SELECTIONS BELOW.
*Male students receive free instruction for Base Package training.
* Additional Classes offered at a discounted rate in Tap, Acro, African, Pointe, Ballet Technique, Leaps & Turns, Stretch & Conditioning and Hip Hop.
* Classes are subject to close due to enrollment.
ALSO OFFERING: a La Carte Classes - No Base Package Required (Select "NO Base Package" above if just wanting a la carte classes) $75/MONTH PER CLASS - Choose # of classes:
LIST all added a La Carte Class Type(s):
Name of Class(es): Tap, Ballet, Jazz, Hip Hop, Acro, African, Modern. BALLET REQUIREMENT for Jazz , Modern, and Acro
SIBLING DISCOUNT REQUEST - Submit 1 form per child:
Medical Information
List any allergies:
Please list. Write NONE if Not Applicable.
BASE PACKAGE PRICING - Please choose one Base Package
prevnext( X )
INTRO TO DANCE - Base Pkg. COMBO CLASS AGES 2.5 - 5/6
Ballet and Jazz @ $100/month (2 hour combo class)

$100.00



BASE PACKAGE ALL LEVELS
Ballet, Modern and Jazz @ $150month (Each class 1 hour)

$150.00



4 CLASSES - Base Pkg. + 1 additional class
Base Pkg. plus 1 additional class of Tap, Acro, Pointe, Hip Hop, African,

$180.00 Choose Additional Class:



5 CLASSES - Base Pkg. + 2 additional classes
Base Pkg. plus 2 additional classes of Tap, Acro, Hip Hop, African or Pointe

$210.00 Choose 2 Additional Classes:



6 CLASSES - Base Pkg. + 3 additional classes
Base Pkg. plus all 3 additional classes of Tap, Acro, Hip Hop, African or Pointe

$240.00



7 - 8 CLASSES - Base Pkg. + 4-5 additional classes
Base Pkg. plus 4 additional classes, Tap, Acro, Hip Hop, African or Pointe

$270.00 Quantity



UNLIMITED CLASSES - Base Pkg. + all additional classes including all Skill Booster add-ons
Base Pkg. plus all additional classes, Tap, Acro, Hip Hop, African, Pointe, including Skill Booster Add-Ons

$300.00 Quantity



SPECIALTY SKILL BOOSTER HALF SEASON ADD ON
Ballet Technique / Leaps & Turns / Stretch & Conditioning Class runs from September through January (no costume fee)

$30.00 Ballet Technique / Leaps & Turns / Stretch & Conditioning
Item subtotal:$0.00



NO Base Package / A LA CARTE
Choosing Class from a La Carte

$75.00
Will your dancer require any medical attention and or special needs during a normal class
If yes, please explain:
Emergency Contact
Name
Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Relation to Dancer
DIP STUDENT POLICIES

Rules / Fees / Legal Release / Policy Acceptance
DOWNLOAD or PRINT this PDF for your records and review. (Top right of document and hit down arrow to save to your device or print.) Sign and agree to all terms, policies and conditions below.
If trouble viewing, please see our Handbook page on our website.
- I/we understand the studio policies
- I/we understand my billing obligations and payments are non-refundable
- I/we understand the risks related to dance
- I/we understand my responsibilities for my property
- I/we understand the dress code
- I/we understand the schedule
- I/we give media use rights permission
- I/we understand the attendance policy
- I agree my dancer understands and agrees to what is expected of them as
- pertaining to all policies and procedures
- I have read and saved a copy of the above DIP Policy PDF for my reference.
Signature of Parent/Guardian
Any questions or additional information?
PLEASE NOTE: AFTER YOU SUBMIT YOUR FORM YOU WILL BE TAKEN TO OUR WEBSITE PORTAL TO MAKE ONLINE PAYMENT.

ALL PAYMENTS ARE DUE AT TIME OF REGISTRATION AND ARE NON-REFUNDABLE.

SIBLING DISCOUNT: PLEASE SUBMIT YOUR FORMS AND CONFIRM WITH DIP FOR PAYMENT AMOUNT BEFORE ONLINE PAYMENT.
Please verify your entry
DIP STUDIOS, LLC
Dance Institute of Philadelphia
3251 Fox Street, Suite 102 Philadelphia, PA 19129
215-416-7368
DIPstudiosLLC@gmail.com
www.DIP5900.com
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DIP DANCER REGISTRATION FORM

STUDENT INFORMATION

Classes & Fees 2024-2025

Medical Information

BASE PACKAGE PRICING - Please choose one Base Package*

DIP STUDENT POLICIES

BASE PACKAGE PRICING - Please choose one Base Package