Adult Classes Dance Registration Form

Adult Classes Dance Registration Form
*Please fill out every page accurately and to your best knowledge.*

*Notice: PLEASE ONLY USE ONE FORM PER STUDENT REGISTRATION, PLEASE REVIEW THE "POLICIES & PROCEDURES" PAGE ON OUR WEBSITE*

Class Pricing:
DANCE CLASSES:
Group Classes: (1hr class/week sessions Tuesdays/Wednesdays Time: TBD based on registration #s)

Sessions:
Adult Tap & Jazz Sessions (1hr/week per discipline)
4 Week Session: $80.00
Register for two 4 week sessions: $150.00 (Save $10)

YOGA CLASSES:
Group Classes: (1hr class/week Wednesdays 7-8pm)

30 week Hatha Yoga Classes (30 weeks Sept-Apr)
Annual: $420.00/yr Due Sept 1st, 2027
Monthly: $52.50/mo (Sept-Apr)

15 week Hatha Yoga Classes (15 weeks Sept-Dec or Jan-Apr)
Annual Sept-Dec: $225.00/yr Due Sept 1st, 2027
Monthly: $56.25/mo (Sept-Dec)
Annual Jan-Apr: $225.00/yr Due Jan 1,2027
Monthly: $56.25/mo (Jan-Apr)

Punch Passes: (ability to attend any Hatha yoga class throughout the season)
5 Classes $75.00
10 Classes $140.00

Sessions:
Mom/Pop & Tot (4 weeks-Sept Wednesdays 11am-12pm) allows attendance of one adult and one child $80.00
Mom/Pop & Tot (8 weeks-Sept-Oct Wednesdays 11am-12pm) allows attendance of one adult and one child $152.00 (save $8.00)
additional children:
$5/child for 4 week session
$10/child for 8 week session

Student Information

Please still fill out contact information on this page
Student Name

First NameLast Name
Student Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Email
example@example.com
Primary Mailing Address

PO BOX #

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Pertinent Medical Information (please list all physical problems that would be pertinent for our instructors to know)
Allergies, Required medications, Food Intolerances, etc.

Payment Plan

This is for future invoicing, NO PAYMENT IS REQUIRED AT THIS TIME PLEASE WAIT FOR A FINALIZED INVOICE.
Payment Policy:
At time of Registration families select a primary payment method below, this method will be used for all invocies during the season. Changes are permitted only by request and approval from administration.
What payment plan would you like for the 2027 Season?
What payment method do you prefer? (Please note our payment policy above).

Liability Waiver Form
I/We the dancer and the parent/guardian) realize that the participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By signing this release form, I/we assume all risks related to the use of all spaces used by Rebound Dance Company and Jesse Berry.

I/We agree to release and hold Jesse Berry including all staff members and facilities used by Rebound Dance Company from any cause of action, claims, or demands now and in the future.

I/We will not hold Rebound Dance Company or Jesse Berry liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes.

Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behaviour in addition to any damage I/we may cause to the facilities utilized by Rebound Dance Company or Jesse Berry.

If, in the event that I/we should observe any unsafe conduct or conditions before, during or after classes. I/we agree to report the unsafe conduct or conditions to Jesse Berry as soon as possible.
Primary Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature
Date Signed
Dancer's Name

First NameLast Name
Dancer's Signature (18+ ONLY)
Date Signed

Rebound Dance Company Photo/Video Release Form
Students of Rebound Dance Company may have the opportunity to be photographed or video taped at various dance events and classes. With permission from parents these photos or videos may be included for Rebound Dance Company publicatons or advertsements, including on our website and various social media sites. To ensure privacy, specific names of children will not be included.

No financial compensaton shall be given for use of any photographs or videos.

I acknowledge that Rebound Dance Company may choose not to use my photo or video at this time, but may do so at its own discretion at a later date.

Rebound Dance Company reserves the right to discontinue use of photos or videos without notice.

I have read this release and I understand its contents.

I consent to and authorize the use by Rebound Dance Company, or anyone authorized by Rebound Dance Company, of any and all photographs or videos which have been taken of my child/children.
Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Dancer's Name

First NameLast Name
Dancer's Signature (18+ ONLY)
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Name

First NameLast Name

I have read and understand all studio policies, procedures and guidelines as outlined in the Studio Handbook and Policies Page on the website. I agree to abide by these policies and understand that it is my responsibility to remain informed of any updates communicated by the studio.
Parent/Guardian Signature
Date Signed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: