Student Enrollment & Release Form: SPROUTS

Dancer Enrollment: SOUTHERN BELLES

Fill out the form carefully for registration
Student Name

First NameLast Name
Birth Date

MonthDayYear
Age
Gender
Parent's or Guardian's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Emergency Contact

First NameLast Name
Phone Number
Format: (000) 000-0000.

Southern Belles Dance Co. Policies & Procedures
Southern Belles rehearsals are held Monday–Wednesday from 6:00 PM to 8:30/9:00 PM, with additional Thursday rehearsals scheduled during competition preparation.

1. ATTENDANCE POLICY

Dancers are expected to attend all rehearsals, performances, and mandatory events.
Two (2) unexcused absences will result in being cut from select routines at the Director’s discretion.
Absences must be communicated in advance by phone or text.
No-call/no-show = automatic unexcused absence.
Excused absences include verified medical emergencies or immediate family emergencies.
Three (3) tardies = one absence. Excessive absences may result in dismissal.

2. HIATUS / BREAKS

Hiatuses are approved only in emergency situations, with documentation if requested.
You are responsible for tuition during any break or period of inactivity.
Dancers inactive for 30 days or more without notice may be dismissed from the team.

3. TUITION & PAYMENT POLICY

Tuition $165 is required for the entire 12-month season, regardless of attendance or break status.
All families are required to enroll in online automatic payments (auto-debit) by the beginning of the season.
Tuition is due by the 5th of each month.
If unpaid after the 5th, a $25 minimum late fee is applied, plus $5 per day until the balance is paid.
If studio rent is penalized due to late tuition, the $125 late fee will be split evenly among all late-paying parents.
Example: 4 late payers → $125 ÷ 4 = $31.25 each.

4. CODE OF CONDUCT

Dancers must show respect, professionalism, and good sportsmanship at all times.
Bullying, disrespectful behavior, or negative energy will not be tolerated.
Social media content related to the team must be appropriate and positive.
Parents must maintain respectful communication with staff, dancers, and each other.

5. PERFORMANCE ATTIRE

All dancers must wear assigned uniforms and correct attire for every practice and performance.
This includes leotards, tights, shoes, team shirts, and performance costumes.
Dancers not in proper attire may be benched for that session.
Hair and makeup instructions for performances must be followed.
Lost or damaged costume pieces must be replaced by the dancer’s family.

6. COMMUNICATION EXPECTATIONS

Official team communication will take place through group text and the Southern Belles private Facebook group.
It is each parent’s responsibility to check both regularly to stay updated on rehearsal changes, payment reminders, and event announcements.
Group text will be used for urgent updates.
Facebook will serve as the hub for flyers, event info, and reminders.
Any personal concerns should be addressed privately with the Director, not in group chats or public comment threads.

PLEASE READ THE FOLLOWING CAREFULLY BEFORE SIGNING

ACKNOWLEDGEMENT AND RELEASE AUTHORIZATION FOR MEDICAL TREATMENT:
MEDICAL/DIETARY QUESTIONS
Physical Condition: Please list any non-allergy physical/medical conditions that would be helpful for us to know about this child.
Medications: Please list the medications and dosage your child is currently receiving, along with any special instructions.
Food Requests: Please indicate any dietary requests due to your child’s preferences, religious practice, lactose intolerance, food sensitivity, or treatment for a behavioral condition. The following requests are NOT due to a food allergy:
Allergies: Has your child been tested and diagnosed for a food allergy by a health care professional? Is yes, please state the allergies below.
LIABILITY WAIVER
In consideration of the acceptance of my application for the above program, I hereby waive, release, and discharge any and all claims for damages for personal injury, property damages or which may hereafter occur to me as a result of participation in said event. This release is intended to discharge in advance Southern Belles Dance Co./Feleké Ross, its officials, officers, employees, volunteers and agents from liability, even though that liability may arise out of perceived negligence on the part of persons mentioned above. It is understood that some recreational activities involve an element of risk or danger of accidents, and knowing those risks, I hereby assume those risks. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and assignees.

I ACCEPT

I HAVE READ THE AGREEMENT, FULLY UNDERSTAND IT, AND GRANT PERMISSION FOR MY CHILD TO PARTICIPATE IN THE PROGRAM IDENTIFIED ABOVE.
Date

MonthDayYear
Date
To complete your dancer’s enrollment, please send your payment via Cash App to:

$FelekeRoss

📌 Include your child’s name in the memo.
Please screenshot and upload proof of payment below.

Cancelof
Print Name
Signature of Parent or Legal Guardian:

Powered by Jotform SignClear
Should be Empty:

Dancer Enrollment: SOUTHERN BELLES

Southern Belles Dance Co. Policies & Procedures