REGISTRATION FORM
Season: September 2022 June 2023
Signup Date:
Season: September 2002 June 2023
Signup Date
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Month
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Day
Year
Date
Student's Name
Date of Birth (MM/DD/YYYY)
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Month
/
Day
Year
Date
Maling Address
Primary Phone
Phone (2)
Name of Person responsible for paying tuition/ co. fees
Primary Email Address
Primary Billing Phone .
Legal Release and Policy Acceptance (Click the box to the left)
I'we understand the Studio Policies
I/we understand my billing obligations
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
Signature / Responsible Party
Date
/
Month
/
Day
Year
Date
Registration Fee
September Tuition
Costume fee (Administration Only)
Concert Fee (Administration Only)
Total Monthly Tuition
Measurements (Administration Only)
Height
Girth (Administration Only)
Girth (Administration Only)
Leotard Size
Leotard Size
Tights Size
Shoe Size
Allergies
Explain
Special Notes
Administrtion only: 11 Recorded 11 IOn hold Processed by
Special Notes
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Emergency Contact Information
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Signature
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Will your child require any special medical attention during normal class (yes/no)
Should be Empty: