Registration Form

Outbreak Dance Studio Registration Form

Outbreak Dance Studio's goal is to create dancers that are well-rounded and instill values and qualities that will last a lifetime. Members will foster a love of dance and will exemplify a high standard that is empowered by community, driven by integrity and dedicated to excellence. All fees PAID to OBDS are non-refundable and non-transferable. Payments are due at the time of registration. Please fill out one form per dancer. A valid card must be on file for electronic payments.
Dancers Name

First NameLast Name
Dancers Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name

First NameLast Name
Parent/Guardian Mobile Number
Please enter a valid phone number.
Parent/Guardian Email Address
example@example.com
Emergency Contact Name

First NameLast Name
Mobile Phone Number
Please enter a valid phone number.
Relationship to Dancer
Is your dancer new or returning to Outbreak?

New DancerReturning Dance
Can your dancer be dismissed without an adult?

YesNo
Will your dancer graduate from High School this school year?

YesNo
Please list and explain any medical conditions, medications taken and food allergies below.
Does your dancer have any dance experience? If yes, please list the genre(s) and number of years taken.
CLASSES AND FEES

ALL fees paid to Outbreak Dance Studio are non-refundable and non-transferable. Payments are due at the time of registration. Please fill out one form per dancer. A valid card must be on file for electronic payments.
REGISTRATION FEE

Early Registration is $25 from July 15th-August 31st (online ONLY).

Late Registration is $50 from September 1st-November2nd (online/in person).

A total bill will be emailed for monthly fees based on the classes taken.
TUITION INFORMATION

Tuition is due one the 1st of each month and is considered late after the 5th of each month. Payments are electronic ONLY. A $35.00 late fee will be applied on the 6th of the month. If a payment declines, a $35.00 fee with be applied.

MONTHLY TUITION

1 Class: $20

2 Classes: $35

3 Classes: $50

4 Classes: $65

Outbreak MINIs: $75

*Outbreak MINIs MUST enroll in Ballet.

Outbreak Training Company: $110

*Outbreak Trainging Company MUST enroll in Ballet and Modern.
CLASS SELECTION
Please select all that apply

Ballet (ages 4-18)Modern (ages 6-18)Jazz (ages 6-18)Acrobatics (ages 5-18)Outbreak MINIs (ages 5-9)Outbreak Training Company (ages 10-14)
Outbreak Dance Studio Release Forms

Photo and Video
I grant Outbreak Dance Studio, its representatives and employees the right to take photographs and or videos of my dancer in connection with their activities within. I authorize OBDS to use and publish the same in print or electronically. I agree that OBDS may use photographs and or videos of my dancer, including, but not limited to advertising, publicity, social media, and web content.

I agreeI disagree
I understand that there are risks of physical injury within the activity of dance. In recognition of this acknowledged risk of injury, I knowingly waive all right, liabilities, claims, demands, or causes of action of any kind to Outbreak Dance Studio. Releasor acknowledges, fully understands and and agrees to hold Outbreak Dance Studio harmless of liability, and hereby acknowledge that I knowingly assume full responsibility for all risk of physical injury arising out of active participation in dance.

I agree
Signature

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Outbreak Dance Studio Registration Form

CLASSES AND FEES

CLASS SELECTION

Outbreak Dance Studio Release Forms