After-School Forms

Please complete our online registration form (ONE Form Per Child). An Email Confirmation Letter will be sent once your child's Registration Form has been received.

Student Information

Name of School *

Student's Name *

First Name Last Name

Grade *

Teachers Name *

Gender *

Male Female

T-Shirt Size *

Parent Information

Parent Name *

First Name Last Name

Parent Home # *

- Area Code Phone Number

Parent Cell # *

- Area Code Phone Number

Authorized Pick-Up

Will your child be going to an ''In-School'' Child Care after dance? *

YES NO

Authorized Name *

First Name Last Name

Authorized # *

- Area Code Phone Number

Medical Information

Does your child have any allergies, chronic illness, or medical conditions? If yes, please describe. *

Waiver/Liability Form

I give permission for my child, whose name is listed on this registration form, to participate in dance classes taught by ‘’Sky’s The Limit Dance Company, LLC’’ herein after (STLDC). I understand that there are risk (i.e. injury, illness, etc.) in taking dance and claim that my child is physically, mentally and emotionally capable in participating in the dance session(s) and activities provided by STLDC. In case of injury, accidents, illness or loss to said child, I hereby waive all claims against STLDC agents, staff/contractors, affiliates, and all participants. If necessary, I authorize agents, staff/contractors of STLDC to administer First Aid and or/authorized medical treatment. If any medical emergency should occur involving my child, I authorize STLDC to take all appropriate steps to notify me immediately of the event, but if I am inaccessible for any reason, I authorize STLDC to seek the diagnosis and treatment by a qualified and licensed medical professional, of the minor child. I authorize STLDC and its contracted photography company, 7Lights Photo, llc, to use photos, recordings and or other likeness’ of my child for whom I have legal guardianship for any promotional materials regarding STLDC programs, facilities, or services. Such likenesses will not be sold to other parties. Promotional materials bearing these likenesses may be distributed for free to the public and posted on the STLDC and 7Lights Photo, llc, website, social media pages, and other materials related to the STLDC program such as but not limited to promotional brochures and media. STLDC and 7Lights Photo, llc, reserves the right to use any photo or likeness for a time period beginning when this form is signed and ending upon written request of participant, parent or legal guardian. I understand that registration is not complete without my full and/or monthly Payment. I also understand STLDC's Payment Policy, in which 100% REFUNDS will be given to parents for registrations canceled BEFORE the start of dance class. And 50% REFUNDS (for ONLY unattended dance classes) will be given to parents for registrations canceled AFTER the start of dance class. Class Cancellations are NON-REFUNDABLE (STLDC will do their best to reshedule a class Make-Up day). Furthermore, I confirm that I am the custodial parent/guardian of said child.

Please Check *

I have read all the information above and agree.

Please leave any additional comments below (including any disagreement(s) to the above Waiver/Liability Form).

Comments

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Parent/Guardian Full Name *

Student's Full Name *

Date *

- Month - Day Year

How did you hear about us? *

E-mail *

ONLINE PAYMENT

NEW STUDENT (NS) / RETURNING STUDENT (RS) / SIBLINGS (SB)

RATES:

NS- Full Rate: $150 / Monthly Rate: $50

RS- Full Rate: $135 / Monthly Rate: $45

SB- Full Rate: $120 per child / Monthly Rate: $40 per child

MAKE PAYMENT: *

USD BALANCE

CANNOT PAY ONLINE: If you are unable to pay online,

Please email Payment.STLDC@gmail.com.

After-School Registration Form!