XPY Enrollment Form

For more information log onto www.thexperiencedc.com
This form is for class and performance- related payments only! To purchase merch or required dance attire, please click HERE
Parent's Name*
Type N/A if older than 18
Email Address*
Address (City, State and Zip)*
Phone Number*
Cell Phone
Are you enrolling, paying for Master Classes or paying performance related fees?

EnrollingPayment-related feesPaying for Master Classes
How did you find out about our program?

InstagramFacebookSearch EngineStudent/ Parent Referral
If you answered Student/ Parent Referral, please enter the individual's name here
Are you only interested in signing up for a $5 trial?

YesNo, I want to enroll

Dancer's Name
Dancer's Name
Dancer's Email
example@example.com
Age
DOB

MonthDayYear
Date
Please list any previous dance experience your child may have
Is this dancer a sibling?

YesNo

Sibling 1
Dancer's Name
If dancer is a sibling, please list the oldest sibling first
Dancer's Email
example@example.com
Age
DOB

MonthDayYear
Please list any previous dance experience your child may have
Sibling 2
Dancer's Name
If dancer is a sibling, please list the oldest sibling first
Dancer's Email
example@example.com
Age
DOB

MonthDayYear
Date
Please list any previous dance experience your child may have

NEW SCHEDULE AND RATES

Effective January 1, 2025

Select your classes

Company/Competition PackageApprentice PackageBallet 1/2 (Intermediate/Advanced)Modern 1//2 (Intermediate/Advanced)Jazz 1/2 (Intermediate/Advanced)Tap 1/2 (Intermediate/Advanced)Hip Hop Combined (Advanced Beginner-Advanced)- 10 and overAcro Combined (Advanced Beginner-Advanced)Petite Combo 1 (Ballet and Modern)- ages 6-9Petite Combo 2 (Jazz and Hip Hop)- ages 6-9Juniors Ballet- ages 10-12Juniors Combo (Jazz and Modern)- ages 10-12Intro to Acro- ages 6-10
IF YOU ARE ENROLLING, PLEASE SUBMIT YOUR ONE-TIME (NON-REFUNDABLE) INCIDENTALS FEE PER CHILD AND YOU WILL RECEIVE A FOLLOW-UP INVOICE REFLECTING THE CLASSES YOU SELECTED ON THE PREVIOUS PAGE.

Incidental Fee (NON-REFUNDABLE)DUE AT THE TIME OF ENROLLMENT (one time fee per dancer to cover miscellaneous unforeseen costuming, operational and performance expenses)- This is not required for the $5 trial

$50.00 Quantity

Classes

Trial Class

$5.00

Class Selection	Quantity
Petites A Combo Class- ages 6-9 (12:00-1:00)
Juniors Technique Class- 10- 12 (2:00-3:00)
Technique class (12:00-1:00)
Master Class (1:00-2:30)

Open Master Class Series(Intermediate/ Advanced (ages 12 & up)

$20.00

Class Selection	Quantity	Price
December 15- Heather Jean Wilson (Fosse) 1-2:30		$20.00
Enrolling in all classes		$35.00

Performance-Related Costs

Sixers PerformancePlease remember that additional costuming cost may apply. THIS PERFORMANCE IS EXCLUSIVELY FOR COMPETITION TEAM MEMBERS ONLY

$50.00

Sixers CostumeANYONE WHO HAS NEVER PERFORMED DETENTION WILL NEED THIS COSTUME! THIS IS SEPARATE FROM YOUR TEAM WARM UP! DANCERS WILL ALSO NEED A PAIR OF BLACK HIGH TOP CHUCKS NOT INCLUDED IN COST

$45.00

Competition DepositThis price will be used toward dancers' upcoming registration fees.

$100.00

Solo Entry Fee

$140.00

Duet or Trio

$75.00

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Would you like your future monthly payments broken into 2 installments for an additional 7% installment fee?

YesNo
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that the activities held at The X-Perience Dance Company are physical in conduct and could potentially result injury. I am aware of the potential risk associated with dance. However, XDC will not be held accountable in the event of a dance/ acrobatic or any physical activity related injury. Upon enrollment, any false statements, omissions, or other misrepresentations made by me on this application may result in my immediate dismissal.
Signature*

Clear
Date

MonthDayYear
Date

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

Dancer's Name

Sibling 1

Sibling 2

NEW SCHEDULE AND RATES