Children's Registration Form & Liability Waiver

1
Date* This field is required.
Month
Day
Year
2
Student Information* This field is required.
Student Name- FIRST , LAST
Birthdate -REQUIRED
Parent/Guardian Name
Cell Phone
Address
City, Zip Code
E-mail/Parent Guardian E-mail
3
Allergies or Health Concerns* This field is required.Please List any allergies or health
4
Please list any prior dance experience (i.e. number of years, dance technique studied, teachers, etc.):
Huge
Large
Normal
Small
Ok
Ok
5
Emergency Contact Information* This field is required.
Contact Name
Relationship to Student
Cell Phone
Email Address
6
Class RegistrationAdvance registering your child in a class secures their space in a weekly class. Your account will be set for monthly auto-payment on the first of each month. If you would like to change classes, or cancel your auto-payment, please notify the studio via e-mail 30 days in advance.
Class Name/Age Group
Class Day/Time
7
LIABILITY RELEASE* This field is required.Indicated in the space below are any health problems or conditions of which the studio should be aware (such as heart, back, medical, allergy, muscular, pregnancy, diabetes, epilepsy, chemical or neurological condition, special medication, knee/kidney/shoulder problems, etc.). I understand that risk of injury is inherent in any physical activity and I knowingly and voluntarily accept that risk. I, the undersigned, for myself, my heirs, administrators, and executors, herby waive and release En Pointe Dance & Fitness, individually and , En Pointe Inc. and its staff from any and all claims or damages of any kind arising out of my participation in the exercise and/or dance program of En Pointe Dance & Fitness. I certify that I am in proper physical condition to participate in the exercise/dance program and that I have been examined by a licensed physician and found to be in proper physical condition to participate in said program. I, the undersigned, do herby authorize En Pointe Dance & Fitness or her designated agents (being teachers or administrators employed by En Pointe Dance & Fitness.) to obtain medical treatment for myself in emergency situations if needed. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make release En Pointe Dance & Fitness responsible for payment of medical expenses. This authority includes the power to authorize any and all treatment deemed necessary under the circumstances by a licensed physician. This power is in essence a power of attorney and shall remain in effect for one year from the date signed below. Permission is granted to En Pointe Dance & Fitness to use photographs of myself or my child for publicity purposes. I have read, understood and agree to be bound by the above statement and have been given a copy of En Pointe Dance & Fitness Studio Policies and Dress Code ( please print your name, sign & date.)
Clear
8
Tuition Policy* This field is required.To attend weekly classes, tuition for children’s classes will be processed on the 1st of each month. Monthly tuition rate will remain the same whether it is a long month (5 classes) or short month (3 classes). We do not prorate tuition for any reason other than a new student starting mid month. Full tuition will be charged monthly, regardless of holidays. There are several months where a 5th lesson is given at no charge. There are no refunds or credits for missed classes. If your child misses a class, they may take a make-up class at a similar level. Please refer to the website for available classes. Make-up classes expire after 30 days. Full tuition is required for the June recital month. If your payment is declined or returned, a $10 reprocessing fee will be assessed. Registration fees, costume fees, and tuition fees are non-refundable and non-transferable. Full tuition will be charged monthly, regardless of holidays. There are several months where a 5th lesson is given at no charge. There are no refunds or credits for missed classes. If your child misses a class, they may take a make-up class at a similar level. Please refer to the website for available classes. Make-up classes expire after 30 days.
Clear
9
Studio Policies & Procedure Acknowlegment* This field is required.Studio Policies & Procedures CHILDREN’S CLASSES PAYMENTS AND POLICIES REGISTRATION FEE: There is an annual registration fee of $40 that is assessed every September. If your child enrolls in classes after September, your registration fee will be charged with our first month's tuition. CANCELATION POLICY: If you would like to cancel your child’s class(s) a written cancellation notice should be sent via email to: enpointestaff@gmail.com 30 days in advance to avoid charges to your account. DROP IN CLASS POLICY: Children are welcome to try other classes by purchasing a drop in class. All drop in classes must be scheduled in advance. Drop in classes are not available for specialty classes or permission classes. CLASS SIZE POLICY: If there is a children’s class with less than 2 students, you will be given the option of doing a half hour private lesson or a make-up on a different day. STUDIO ETIQUETTE LATE ARRIVALS: Students should arrive at least 10 minutes before class so they will be ready to begin. Entering class after it has begun is disruptive to the teacher and other students. If the student is tardy, please enter class quickly and quietly. Because they have missed crucial warm-up time, dancers who arrive more than 10 minutes late may be asked to observe the remainder of class. PLEASE DROP OFF & PICK UP PROMPTLY: Students should arrive NO MORE than 10 minutes prior to the start of class & picked up NO LATER than 10 minutes after class. If your child is picked up more than 15 minutes after their class is over, a child care fee of $20 will be imposed. The parking lot and other outside areas are NOT playgrounds. Parents must monitor their children when they are outside of the studio. Students should only be outside when coming to class or leaving class. ABSOLUTELY NO gum, food or drinks are permitted in any of the dance rooms, except water. If your child has a smart watch, we ask that they please leave them in their dance bag. They are welcome to check them for messages during water breaks and after class. If you have an emergency and need to reach your child, please call the studio and we will call them out of class to speak to you. Excessive talking or other misbehavior will not be tolerated and may result in the student being asked to observe class instead of participating. All students must respect the structure and teaching style of all instructors. CLASS OBSERVATION: Although the physical design of our studio allows parents to watch at any time, even the quietest observers distract students and can make them self-conscious or apprehensive if they are constantly watched. Please DO NOT enter the classroom during the course of the class for any reason even if the class is changing shoes or taking a break. ** Siblings not participating in a dance class must be accompanied by a parent at all times and are not allowed to run or play in any area of the studio. If you would like them to do homework at the back hallway tables please check the front desk for availability. ** APPROPRIATE DANCE ATTIRE FOR CHILDREN’S CLASSES Dance attire is encouraged for all of our dancers. Dance attire allows the instructors to see your dancer's lines and helps them to make the appropriate corrections. Below is a list of suggested attire. CHILDREN’S BALLET: Solid color leotard, tights and ballet shoes. Ballet skirts are optional. Hair should be worn in a bun, or out of the face. TAP & JAZZ: Any leotard & tights, jazz pants or shorts. Tap or Jazz shoes. Hair should be pulled out of the face. CONTEMPORARY/LYRICAL: Any leotard & tights, tank top, jazz pants or shorts, dance top. Bare feet, or half sole shoes. Hair should be pulled out of the face. HIP-HOP: Athletic shorts or pants with a fitted dance top or t-shirt. Any tennis shoes are acceptable as long as they are not backless or open toed. **This is the only class in which street clothes are appropriate. NO BLACK OR COLORED SOLED SHOES ALLOWED.
Clear
10
Annual Registration FeeAll dancers will be charged a yearly registration fee. If you have more than one child dancing at the studio, the initial child must pay the Individual Fee, any additional siblings my pay the discounted sibling fee.
prevnext( X )
My Bag
1
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Yearly Registration Fee-IndividualAnnual Registration Fee for all dancers.
$40.00Edit
Back
Yearly Registration Fee -Additional Sibling (Must pay Individual for 1st child)First sibling must pay Individual fee, addition siblings may pay sibling fee.
$20.00Edit
Back
Total cost $0.00
Payment Methods
Credit Card
First Name
Last Name
Google Pay
After submitting the form, you will be redirected to the Google Pay to complete the payment process.
Apple Pay
After submitting the form, you will be redirected to the Apple Pay to complete the payment.
Should be Empty: