Downtown Dance: Registration 2019-2020

435 N. 10th Street in Lewisburg
ONLINE REGISTRATION FORM
It's our 10th Anniversary Year!

Classes start Monday, August 26.
Need class recommendations? Email Christine at DowntownDancePA@gmail.com or call 570-768-9379.
IMPORTANT-
Add "DowntownDancePA@gmail.com" to your Contact List or Address Book so you receive our email communications!
Make sure we have the best email address(es)!
Studio Schedule 2019-2020
Today's Date*

MonthDayYear
Student's Name*

First NameLast Name
Sibling's Name

First NameLast Name
Sibling's Name (Student 3)

First NameLast Name
Parent's Name*

First NameLast Name
Parent's Primary Email*
example@example.com
Secondary Email*
example@example.com
Mom's Cell Number*

Area CodePhone Number
Dad's Cell Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact, Relation, & New Cell #*
How did you hear about us?*

Current/Past StudentFrom a FriendFacebookInstagramGoogle SearchLocal PerformanceOther
Student's Birthday*

MonthDayYear
Date
Sibling's Birthday

MonthDayYear
Date
Sibling's Birthday

MonthDayYear
Date
Students' Age(s) on Aug. 27, 2019*
Students' School(s)*
Does the dancer have any medical problems that we should be aware of? If yes, please explain.*
Please read the schedule before selecting your class below. It shows more details (ie if a class requires experience, class length, & the teacher's name)
Monday Class Selection:

Mon HH Intermediate 5:40pm (teen)Mon Hip Hop Jazz Fusion 7:15pm (ages 9-12) *ALMOST FULL*
Tuesday Class Selection:

Jazz Intermediate. 6:30pm (ages 10-13)Lyrical/Contemporary 6:30pm (ages 9-12)Lyrical/Contemp. Intermediate 7:15pm (ages 10-13)
Wednesday Class Selection:

Wed Jazz/Tap 4:50pm (ages 6-8) *ALMOST FULL*Wed Ballet/Tap 5:40pm (ages 5-7) *ALMOST FULL*Wed Ballet Technique 5:40pm Fall Session only (ages 7-10)
Thursday, Friday, Saturday Class Selection:

Thu Itty Bitty Ballet/Tap 4pm (ages 4-5) *HAS SPACE!*Thu Hip Hop/Tap 4:50pm (ages 5-7) *ALMOST FULL*Thu Ballet 1 4:50pm (ages 6-8) *ALMOST FULL*Thu Ballet Technique 6:30pm (experienced,Tween/Teen) Fall session onlyFri Tap Intermediate (10+) 5:15pmThu Musical Theater
If registering for siblings, please specify which child is taking which class
You MUST download &/or print the Registration Packet. It contains:
- Our Calendar (Holidays, Open vs. Closings, etc)
- How Do I Pay?-Payment Option information
- Auto-Monthly "ACH FORM"
- Special notes about our Ballet Technique Fall Session only class & other notes for new student shoes/dress
I understand that payment due dates are listed in the registration packet that I have downloaded. Late payments incur a late fee of $10 per occurrence.
Signature & Date*
I understand that the return fee for a bad check is $35.
Signature & Date*
I understand that tuition is NOT refundable.
Signature & Date*
By checking this box, I hereby release Downtown Dance employees and independent contractors, from all liability from personal injury, illness or property damage occuring on or off the studio's premises. I have read Downtown Dance's 2019-2020 Registration Packet. I authorize Downtown Dance to discharge my child to an ambulance with the nearest medical facility, should there be a medical emergency. I certify that my student is in good health and capable of participating in physcial activities. I hereby give permission to Downtown Dance to take and use photos and videos for the promotional uses of the studio. This includes, but is not limited to, the studio's facebook, instagram, twitter accounts and Youtube channel where students' names are not disclosed.
I've read the above waiver.*

I agree
Signature / Date*
Dancers are expected to be enrolled through the May Recital. The Recital is the culmination of our School Year Program. Our tentative dress rehearsal & recital dates are May 14 & 15, 2020. Please save May 14-17.
Dancers must register to try the first class.
Will you be paying in thirds or via 'ACH" auto-monthly? For ACH, we will need your form returned by the due date.*

ThirdsAuto-Monthly "ACH"
Registration Fee Payment
prevnext( X )
Registration$15.00

Wertman $260.00

1 Class$150.00

2nd Class +$92.00

Sibling Registration$15.00

Sibling's 1st Class +$100.00

Ballet Technique- Fall Session Only$165.00

3rd Class +$86.00

4th Class +$80.00

5th Class +$80.00

Sibling's 2nd Class +$92.00

Sibling's 3rd Class +$86.00

Siblings 4th Class$80.00

Sibling Registration$15.00

Total $0.00
Should be Empty: