Dotty McGill Dance Registration Form
Multiple Sibling Registration
Student 1
*
First Name
Last Name
New or Returning Student
*
New Student*
Returning Student
*For new students- How many years have you danced
*
Date of Birth
*
-
Month
-
Day
Year
Date
Age as of September 1st 2025
*
Classes Selection - Level Placement based on instructor recommendation – *Prior class attendance and/or age requirements may be required. **Classes will be taken according to team level and ability
*
Tiny Tots (2-year-old)
Kinder Kids Age 4 Tap/Ballet Combo
Mini Movers Age 3 Combo Class
Tap/Ballet Level I Age 5+*
Tap/Ballet Level II*
Tap/Ballet Level III*
Tap/Ballet Level IV*
Kinder Acro*
Acro*
Tap*
Ballet/Cecchetti*
Jazz*
Competition Team**
Student 2
*
First Name
Last Name
New or Returning Student
*
New Student*
Returning Student
*For new students- How many years have you danced
Date of Birth
*
-
Month
-
Day
Year
Date
Age as of September 1st 2025
*
Classes Selection - Level Placement based on instructor recommendation – *Prior class attendance and/or age requirements may be required. **Classes will be taken according to team level and ability
*
Tiny Tots (2-year-old)
Kinder Kids Age 4 Tap/Ballet Combo
Mini Movers Age 3 Combo Class
Tap/Ballet Level I Age 5+*
Tap/Ballet Level II*
Tap/Ballet Level III*
Tap/Ballet Level IV*
Kinder Acro*
Acro*
Tap*
Ballet/Cecchetti*
Jazz*
Competition Team**
Student 3
First Name
Last Name
New or Returning Student
New Student*
Returning Student
*For new students- How many years have you danced
Date of Birth
-
Month
-
Day
Year
Date
Age as of September 1st 2025
Classes Selection - Level Placement based on instructor recommendation – *Prior class attendance and/or age requirements may be required. **Classes will be taken according to team level and ability
Tiny Tots (2-year-old)
Kinder Kids Age 4 Tap/Ballet Combo
Mini Movers Age 3 Combo Class
Tap/Ballet Level I Age 5+*
Tap/Ballet Level II*
Tap/Ballet Level III*
Tap/Ballet Level IV*
Kinder Acro*
Acro*
Tap*
Ballet/Cecchetti*
Jazz*
Competition Team**
Student 4
First Name
Last Name
New or Returning Student
New Student*
Returning Student
*For new students- How many years have you danced
Date of Birth
-
Month
-
Day
Year
Date
Age as of September 1st 2025
Classes Selection - Level Placement based on instructor recommendation – *Prior class attendance and/or age requirements may be necessary. **Classes will be taken according to team level and ability
Tiny Tots (2-year-old)
Kinder Kids Age 4 Tap/Ballet Combo
Mini Movers Age 3 Combo Class
Tap/Ballet Level I Age 5+*
Tap/Ballet Level II*
Tap/Ballet Level III*
Tap/Ballet Level IV*
Kinder Acro*
Acro*
Tap*
Ballet/Cecchetti*
Jazz*
Competition Team**
Parent or Guardian
*
First Name
Last Name
Relation to Students
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
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Payment Agreement
I agree to be responsible for tuition payments until notification of withdrawal. If withdrawal is necessary, I understand that advanced written notification must be submitted to the dance studio one month prior to withdrawal. If the dance studio is not notified, my account will remain active and I will be responsible for tuition, regardless of student absences. I know that payment is due by the 10th of each month. I will give credit card authorization to be used in case of late payment, any tuition not paid by the 11th of the month will be charged to that credit card along with a $10 LATE FEE. I am aware that there are NO REFUNDS or DEDUCTIONS for classes not attended. Tuition payment is due monthly September 2025-June 2026.
*
Waiver and Release Agreement
I, the undersigned parent or guardian of the minors listed above, upon signing this agreement do hereby acknowledge that the activities that I have requested my daughter/son participate in may be stressful on the body and carry with them the risk of physical injury. Therefore, I hereby release, discharge, and agree to hold harmless and safe from any and all liabilities DOTTY MCGILL SCHOOL OF DANCE (Annita J. Garvey DBA Dotty McGill School of Dance) and any of the teacher or assistants from any and all claims, demands, actions, and causes of action arising out of the activities of said business, specifically including dance, acrobatics and related classes, practices and performances.With the above in mind and being fully aware of the risks and possibility of injury involved, I consent to have my child participate in the program offered by Dotty McGill School of Dance (Annita J. Garvey DBA Dotty McGill School of Dance). I do waive and release all rights and claims for damages that I or my child may have against DOTTY MCGILL SCHOOL OF DANCE (Annita J. Garvey DBA Dotty McGill School of Dance) and/or it’s representatives whether paid or volunteered.
*
Photo/Video Release
Dotty McGill School of Dance may use photos or video of your children for social media, website, news releases, marketing and advertising or other publicity. Please sign below to grant your permission to use your child's photo/video for the purposes listed above.
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Emergency Contact
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Medical Consent
It is the policy of DOTTY MCGILL SCHOOL OF DANCE (Annita J. Garvey DBA Dotty McGill School of Dance) and/or staff to notify a parent when a child is in need of medical attention. Occasionally, we cannot contact a parent/guardian and need immediate help for a student.
Please sign below to allow DOTTY MCGILL SCHOOL OF DANCE (Annita J. Garvey DBA Dotty McGill School of Dance) to take appropriate action on behalf of your child.I, THE PARENT/GUARDIAN OF THE MINORS LISTED ABOVE, UNDERSTAND THAT MY SIGNATURE ON THIS AGREEMENT GIVES MY CONSENT TO THE STAFF OR THOSE REPRESENTING DOTTY MCGILL SCHOOL OF DANCE TO TRANSPORT MY CHILD TO A HOSPITAL OR CALL ANAMBULANCE SO EMERGENCY CARE CAN BE GIVEN. I ALSO GIVE MY PERMISSION TO ADMINISTER EMERGENCY CARE.
Medical Condition (Please list any allergies, physical challenges, or chronic conditions that we should be aware of.)
*Credit Card Authorization must be filled out and mailed in or brought to studio to complete registration.
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