EQUINOX DANCE REGISTRATION 2026-2027

Equinox Dance Company Registration Form

2026-2026
Type of Registration?
Current School Year
Student's Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Current Age
Address

Address

Street Address Line 2

CityState / Province

Zip Code
Dancer's Cell Phone
Format: (000) 000-0000.
School Attended
Current Grade
Do you need to prepare to enter a Dance Magnet program?
Yes or No - If yes, please provide grade and school (i.e., MAS, 6th Grade).
Are you a current EXCO student?
Parent(s)/Guardian(s) Information
Mother's Name
Mother's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent's Email Address
example@example.com
Father's Name
Father's Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Studio communications are shared through our free WhatsApp Community. Please provide the phone number where you would like to receive studio announcements and important updates.
Best parent contact for informationFormat: (000) 000-0000.
Emergency Contact/Information:
Physician's Name
Hospital Preference
Please list any allergies you may have (food, medicine, etc.):
If Epi-Pen is required, you MUST advise staff.
Does your child suffer from a medical condition, including any requiring maintenance medication (i.e.Diabetic, Asthma, Seizures)?
Aside from guardians listed above, who can we contact in case of medical emergency:
Relationship to Dancer:
of non-guardian emergency contact
Phone #
of non-guardian emergency contact aboveFormat: (000) 000-0000.
I understand that will be notified in the case of a medical emergency involving my child. I understand emergency services may be called and my child may be transported, by any means, to receive additional care. Parent’s/Guardian’s Initials:
List of person(s) authorized to pick up student:
Is there anyone NOT authorized to pick up student:
BELOW QUESTIONS FOR COMPANY DANCERS ONLY:

(all others move ahead to "Release")
Insurance Company Name (Company Only)
FOR COMPANY MEMBERS ONLY
Policy Number (Company Only)
FOR COMPANY MEMBERS ONLY
Do you have a dance goal? (Personal goal? Make a team? School audition? College Prep? Etc.)
The more specific, the better we can help you reach your goals.
Please list prior dance experience (i.e. number of years, technique training, companies, etc.)
New EXCO Company Members only
Are you on a school Dance Team?
If yes, which one?
Release and Authorization - Required for participation in any program or activity at Equinox Dance Company.

Please read and Initial below:
I hereby give permission for my child to be photographed or videotaped by Equinox Arts Academy, Inc. The photograph, video or interview may be reproduced and released for use by the media, i.e., newspapers, brochures, videos, Instagram, Facebook, Twitter including any and all social media. Parent’s/Guardian’s Initials:
I authorize my child to walk to shops within the same plaza WITHOUT an Equinox Arts Academy, Inc. employee. (Harry's, Dollar Tree, Boba, etc)
Equinox Arts Academy and its co-organizers are not responsible for lost or damaged personal property. No Lost & Found will be stored for over a week. Parent’s/Guardian’s Initials:
I understand that no fees/tuition will be refunded, prorated, or transferred due to absence – even for those absences due to an “act of God” or illness resulting in unforeseen circumstances. Payment WILL NOT be shorted when months have holidays or days off. Monthly tuition is payable in full - every month of the season, from registration through June 2026. Failure to pay complete month will require new registration fee to be payable. Parent’s/Guardian’s Initials:
I understand and commit that tuition is due by the 1st of the month. Late fee will be automatically assessed on the 7th of the month if tuition has not been paid; services will be suspended by the 10th. Automatic credit card charge, plus a $20 late fee, will be billed the 7th of the month utilizing mandatory Credit Card on file only IF tuition has not been paid via another payment source. There is no stop and resume. Must re-register. For instance you must still pay fully for November/December. No extra services (privates, merchandise, competition, etc. will be provided/distributed if any tuition or fees are outstanding). Parent’s/Guardian’s Initials:
All scheduled events are subject to change. Equinox Arts Academy reserves the right to combine/ cancel classes and provide substitute teachers at any time. Parent’s/Guardian’s Initials:
I/we understand the following:
I understand that risk of injury is inherent in any physical activity and I, on behalf of myself and my child, knowingly and voluntarily accept that risk. I, the undersigned, for myself, my heirs, administrators, and executors, hereby waive and release Equinox Arts Academy, Inc. its employees, owners, contractors, and its staff from liability and any and all claims or damages of any kind arising out of my child’s participation in the exercise, dance program, and/or any activities of Equinox Arts Academy, Inc. I further certify that the student is in proper physical condition to participate in the exercise/dance program and that he/she has been examined by a licensed physician and found to be in proper physical condition to participate in said program. I, the undersigned, do hereby authorize Equinox Arts Academy, Inc. or her designated agents (being teachers or administrators employed by Equinox Arts Academy, Inc.) to obtain medical treatment for my said child in emergency situations where I cannot be reached in time to authorize the treating physician to provide such emergency medical services. I understand that I am responsible for any medical expenses and that the absence of health insurance does not make Equinox Arts Academy, Inc. responsible for payment of medical expenses.
DATE

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Are you registering for After School Care? ($35/wkly, paid monthly)
Thank You For Choosing Equinox Dance Company!

Welcome to Season 11: The NeXt
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Equinox Dance Company Registration Form

Release and Authorization - Required for participation in any program or activity at Equinox Dance Company.

Thank You For Choosing Equinox Dance Company!