iBalance Dance Studio Registration Form

Return Student*

YesNo

Student Name*

First NameMiddle NameLast Name

Birth Date*

MonthDayYear

Gender*

How old will your child be by September 2024?*

Mailing Address*

Street Address

CityState / Province

Postal / Zip Code

Parent's Name:

First NameLast Name

Parent's E-mail*

example@example.com

Secondary Parent's E-mail

example@example.com

Parent's Number*

Secondary Phone Number

Additional Student Name

First NameMiddle NameLast Name

Additional Dancer Birthdate:

Date

Gender

Please provide us with your child clothes size:*

Please provide us with your child shoes size: (some dance shoes will be need to be purchased with us, those shoes are listed below)*

How did you hear about us?*

Return StudentFacebook/InstagramGoogle/Search Engine

Does your child have any dance experiences:*

What classes are you registering for today?*

COMBO Level II Ballet Modern Jazz (ages 10-13 year old) aka Level I-B 3 SLOTS LEFTLadybug's COMBO Ballet, Tap, Jazz (ages 5-7 years old) 5 SPOTS LEFT!!Adult Jazz (ages 18 & up)

(Additional Student) What classes are you registering for today?*

COMBO Level II Ballet Modern Jazz (ages 10-13 year old) aka Level I-B 3 SLOTS LEFTLadybug's COMBO Ballet, Tap, Jazz (ages 5-7 years old) 5 SPOTS LEFT!!Adult Jazz (ages 18 & up)N/A

Accident Waiver: I hereby grant permission for my child/children to participate in dance that includes physical activity at iBalance Dance Studio. I waive the right to any legal action against iBalance Dance Studio and its staff for any injury sustained on studio premises before, during and after classes or events outside the studio. I understand that I am enrolling my child/children in a program of physical activity and have agreed that my child/children is in good physical condition and does not suffer from any physical disability that would prevent or limit participation in this dance program.*

Medical Wavier Consent: I hereby grant permission for any and all medical attention to be administered to my child/children in the event of an accidental injury or illness, emergency or non-emergency situation until such time as I can be contacted. I also assume the responsibility for the payment of any such treatment. I will assume all responsibility for payment(s) of medical treatment and that iBalance Dance Studio and its staff will not be responsible for any medical costs.*

Photo Release and Agreement : I give full rights to the iBalance Dance Studio and its staff to use photos and video images of me or my child to use for promotional purposes of iBalance Dance Studio only. Photos and videos will be used in brochures, websites, advertisements, and other promotional material created by the studio. Photos may appear with or without names in press releases and other print advertising.*

Physical Contact: Further I understand and acknowledge that because of the physical nature of DANCE, there may be physical contact between directors, instructors and students during rehearsals, shows and especially during dance instruction. I understand that at times for proper instruction and safety, physical contact may be necessary.*

Tuition & Fee's : I hereby agree to the payment agreement schedule for charges incurred at iBalance Dance Studio LLC until my account balance is paid in full. My failure to make payments without notification may result in further collection action. A non-refundable registration fee is due upon registration for the dance program which includes 1 leotard per student. First month tuition may be due at the time of registration, thereafter tuition will then be due on the 5th day of each month, after registration. There is a 20% discount applied if there is a 2nd and/or 3rd family member enrolled in the program, this excludes registration fee, recital fees and costume fees. Costume fees are separate from registration and tuition and must be paid in installments. Installment schedules will be given at orientation for parents/ students. The non-refundable monthly tuition amount does not change if the student is absent or if there are varied numbers of weeks in the month. Taking make-up classes is highly encouraged, and is to be announced. I understand that recital fees, costumes are separated from monthly tuition and statements for these fees will be applied during the course of the dance program.*

Privacy Policy: iBalance Dance Studio LLC is committed to maintaining robust privacy protections for our students and parents. We collect personal information that includes you and/or student name, date of birth, email, contact information, banking information (if applicable) and which you submit to us through the registration process at the site. iBalance Dance Studio LLC does not sell, trade, rent or otherwise share your personal information with third parties without your consent. We do share personal information with vendors who are performing service for iBalance Dance Studio, such as the servers for our email communications who are provided access to the user's email address for purposes of sending emails from us. Those vendors use your Personal Information only in our direction and in accordance with our Privacy Policy. Your account is protected by your account password on the “parent’s portal” and we urge you to take steps to keep your personal information safe by not disclosing your password and by logging out of your account after each use. You have the right at any time to prevent us from contacting you. When iBalance Dance Studio LLC sends a promotional communication to a user, the user can opt out of further promotional communications by following the unsubscribe instructions provided in each promotional email. By using our Service, you acknowledge that you understand iBalance Dance Studio LLC privacy policy.*

Social Media Policy: iBalance Dance Studio LLC students may not use social media in a way which will reflect negatively on iBalance Dance Studio. Students should be aware of the effect their actions may have on their images, as well as iBalance Dance Studio LLC’s image.*

My Products*

New Student Registration includes leotard and 2 pair tights

$120.00 Quantity

Return Student Registrationincludes 2 pair of tights

$85.00 Quantity

Black Leotard

$28.00 Quantity

IBDS Dance Duffle Bag

$40.00 Quantity

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

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

Student Registration Form 2024-2025