2024-2025 Registration Form

2024-2025 Registration Form
Dancer's Name:*

First NameLast Name
Dancer's Age*
Dancer's T-shirt and Pants size*
Desired Classes (Select all that apply):*

Competition Team (Sundays 1-5pm)3-6 Combo Class (Mondays 4-5pm)7 & Up Combo Class (Mondays 5-6pm)Ballet Class (Mondays 6-7pm)Jazz Class (Mondays 7-8pm)Stretch and Strength Class (Tuesdays 6-7pm)Tumbling Class (Tuesdays 7-8pm)Tap Class (Wednesdays 7-8pm)
Does your dancer have allergies?*

YesNo
If yes, please specify.
Emergency Contact Information

Please enter the name of parent or guardian who should be contacted in case of an emergency.
Relationship:*

SiblingParentChildFriendOther
Full Name*

First NameLast Name
E-mail Address*
example@example.com
Contact Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
I, First Name Last Name , under the terms of this Agreement and sufficiency of which is hereby acknowledged, do hereby release and forever discharge Misty's Dance Gallery, including their agents, employees, successors and assigns, and their respective heirs, personal representatives, affiliates, successors and assigns, and any and all persons, firms or corporations liable or who might be claimed to be liable, whether or not herein named, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, which I and my child, First Name* Last Name* , now have or may hereafter have, arising out of or in any way relating to any and all injuries and damages of any and every kind, to both person and property, and also any and all injuries and damages that may develop in the future, as a result of or in my use or my child's use of facilities and participation in activities.

I, First Name Last Name , agree to allow Misty's Dance Gallery to use my child's image and first name only in any or all social media posts, advertisements, and promotions
Signature*

Clear
Date*

MonthDayYear
Date

Starting Bundles

3-6 Combo Class Monthly

$30.00 Quantity

3-6 Combo Class Fall Semester Product Image

3-6 Combo Class Fall SemesterAugust-December (One Free Class)

$100.00 Quantity

3-6 Combo Class YearlyAugust-May (2 Free Classes)

$200.00 Quantity

7 & Up Combo Class Monthly

$30.00 Quantity

7 & Up Combo Class Fall Semester Product Image

7 & Up Combo Class Fall SemesterAugust-December (One Free Class)

$100.00 Quantity

7 & Up Combo Class YearlyAugust-May (Two Free Classes)

$200.00 Quantity

Ballet Class Monthly

$30.00 Quantity

Ballet Class Fall Semester Product Image

Ballet Class Fall SemesterAugust-December (One Free Class)

$100.00 Quantity

Ballet Class YearlyAugust-May (Two Free Classes)

$200.00 Quantity

Jazz Class Monthly

$30.00 Quantity

Jazz Class Fall SemesterAugust-December (One Free Class)

$100.00 Quantity

Jazz Class YearlyAugust-May (Two Free Classes)

$200.00 Quantity

Tumbling Class Monthly

$30.00 Quantity

Tumbling Class Fall Semester Product Image

Tumbling Class Fall SemesterAugust-December (One Free Class)

$100.00 Quantity

Tumbling Class YearlyAugust-May (Two Free Classes)

$200.00 Quantity

Stretch and Strengthen Monthly

$30.00 Quantity

Stretch and Strengthen Fall Semester Product Image

Stretch and Strengthen Fall SemesterAugust-December (One Free Class)

$100.00 Quantity

Stretch and Strengthen Yearly Product Image

Stretch and Strengthen YearlyAugust-May (Two Free Classes)

$200.00 Quantity

Competition Team MonthlyIncludes Team Practices and Two Classes per week (Reduced Rate on Regular Classes)

$40.00 Quantity

Company LeotardXXS Child-XL Adult. Leotard color will be assigned by level.

$20.00 QuantitySize

3-6 Leotard Combo SetIncludes Leotard, Ballet Shoes, and Tap Shoes. Leotard color will be assigned by level.

$55.00 QuantityLeotard SizeShoe Size

7 & Up Leotard Combo SetIncludes Leotard, Ballet Shoes, Jazz Shoes, and Tap Shoes. Leotard color will be assigned by level.

$85.00 QuantityLeotard SizeShoe Size

Boys Company TankXS Child-XL Adult. Tank Top color will be assigned by level.

$15.00 QuantitySize

Boys Company ComboIncludes Tank Top, Jazz Shoes, and Tap Shoes. Tank Top color will be assigned by level.

$60.00 QuantitySizeShoe Size

Company SkirtOnly Available in Child Sizes.

$15.00 QuantitySize

Company ShortsXS Child- XL Adult

$15.00 QuantitySize

Jazz Shoes

$25.00 QuantityShoe SizeColor

Ballet Shoes

$20.00 QuantityShoe Size

Child Tap Shoes

$20.00 QuantityShoe SizeColor

Lace Up/ No Lace Tap Shoes

$25.00 QuantityShoe SizeColor

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

Should be Empty:

2024-2025 Registration Form

Emergency Contact Information

Payment Methods