Folklorico Dance Registration Form 2026-2027

Dancer's Name

First NameMiddle NameLast Name

Gender

Dancer's Date of Birth

Dancer's Age

Parent Name

Address

Street Address

CityPostal / Zip CodeCountry

Parent E-mail:

example@example.com

Mobile Number

Format: (000) 000-0000.

Work Number

Format: (000) 000-0000.

Emergency Contact Name

First NameLast Name

Emergency Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

Class Level

I understand that my child will have a required practice wear that must be bought through Ritmo de Mi Tierra Folklorico Dance Studio. Practice wear is a separate cost.

Practice Shirt Size. Please specify Youth or Adult size. Cost $10 per Shirt

I understand I need to have my child dropped off and picked up according to schedule time. (If accommodations need to be made please talk to Director)

I understand that classes are closed to parents, guests, and public. Therefore only dancers are allowed in the studio during instruction time. A meeting must be scheduled with Director if you have questions or concerns.

I understand that my child will have 3 Strikes (misbehaving during class time) this includes: talking back to the Instructor, fighting with other dancers, using bad words and missing class sessions more than 2 consecutive times. After the 3rd one consequence: Dancer will be expelled from the studio.

If your child needs assistance to use the restroom do you allow a female teacher to assist? If registering as an Adult please select NA

I, the undersigned parent/legal guardian, authorize Ritmo de Mi Tierra Folklorico Dance Studio to photograph and/or record my child during classes, rehearsals, performances, competitions, and studio events. I understand and agree that these photos/videos may be used on the studio’s social media platforms, website, promotional materials, and other studio-related publications. No compensation will be provided for the use of these images or recordings.

I, the undersigned parent/legal guardian, understand that my dancer may be required to purchase at least one folklórico costume based on the state/region assigned to their class at Ritmo de Mi Tierra Folklorico Dance Studio. I also understand that competition participation may require additional fees, including registration, entry fees, and required studio attire such as shirts, jackets, sweatpants, duffle bags, etc.

I understand that this is a competitive studio and that my child is required to participate in competitions unless otherwise instructed or discussed with Director Adrian Valdez

**Liability Disclosure** 1. I/My child is accepting to be part of Ritmo de Mi Tierra under the direction of Adrian Garcia Valdez and Assistant. 2. I agree to assume full responsibility for any risks, injuries and/or damages. 3. I waive any claim I may have against Ritmo de Mi Tierra LLC. Adrian Garcia Valdez or Assistant for injuries I/My child may sustain as a result of participating. 4. I understand I am monetary responsible for any damage of studio property cause by Myself/My child. 5. I have read and understand the above release and waiver of liability. I voluntarily agree to the terms and conditions stated above.

Registration fee $45

Monthly Tuition Fee is $100

For Adult Class $75

due every 5th of the month.

**Fall Semester starts August 3rd, 2026**

Limited spots available.

-10 dancers Max. per class

I understand payments should be on time Cash or through CashApp (if CashApp I MUST include if payment is for Tuition, Practice wear, Costume, etc.) If Tuition payment is not sent on time there's a $20.00 dollars late fee.

I understand that my child is not registered until payment is sent and received.

To complete your 2026-2027 registration form.

Please submit your payment via CashApp to: $RitmodeMiTierra or cash directly with Mr. Adrian

*If registration fee is not paid your Son/Daughter (or Yourself) is not registered*

Thank you for choosing us y a Zapatear!

Parent/Guardian Signature