Dance Registration Form 2025-2026 Season

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Information for Parents/Guardians:  Classes are 1 night a week for an hour. Every student will learn tap, ballet and jazz within that hour for $50 a month. No Registration Fee. If you register late you are still responsible to pay for the months you were not in class.

Class Schedule for 2026-2027 Dance Season

Grades 1st-2nd Thurs from 5-6pm/ Grades 3rd-5th Wed from 6:30-7:30pm/ Grades 6th-High School Wed from 7:30pm-8:30pm/  Ages 3-Kindergarten Wednesday from 5:30pm-6:30pm

Classes start the week of Sept 16th-17th. Each student will need to wear a leotard with/without a skirt (any color) or a tank top and leggings/shorts with short socks or tights, pack a bottled water in a bag or backpack and bring both pairs of shoes (tap and ballet shoes) to every class. You may purchase these items during our open house in August, online or on the first day of class. Studio email is kbartleyre@bellsouth.net/ text or call 502.836.3013 with questions.
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Name of Student
First Name
Last Name
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Address of Student
Street Address
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Are there any medical conditions or allergies?
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Assumption of Risk/Waiver of LiabilityAs legal guardian of the above named persons, hereafter, child I hereby consent to his/her participation in Katrina's School of Dance program. I recognize that potentially severe injuries, including permanent paralysis or death can occur in any activity involving height or motion, including but not limited to dance, gymnastics, special events and camps. I understand that it is the express intent of Katrina's School of Dance to provide for the safety and protection of my child, while participating and in consideration for allowing my child to use these facilities, I hereby release Katrina's School of Dance it employees, demonstrators, senior level students and teachers from all liability for any and all damages and injuries suffered by my child while under the instruction, supervision or control of Katrina's School of Dance.
YESNO
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Permission to TreatAs a legal guardian of the aforementioned person, I hereby agree to individually provide for the possible future medical expenses which may be incurred by my child as a result of any injury sustained while training at or performing at Katrina's School of Dance. This acknowledgment of risk and waiver of liability, having read thoroughly and understood completely, is signed voluntarily as to its content and intent. I confirm that my child is in good health and that I have medical insurance on my child and will provide coverage while he/she is enrolled. I hereby authorize simple first aid and sent to any x-ray, exam and medical or surgical diagnosis that is deemed necessary in case of emergency and release, discharge and covenant not to sue for any negligent medical efforts expended on my behalf or on behalf of the minor. I hereby agree to individually provide for all possible future medical expenses which may be incurred by my child as a result of any injury sustained while participating at Katrina's School of Dance.
YESNO
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Payment PolicyI understand when enrolling my child for classes they will be re-enrolled monthly and I will be charged , unless I notify the office in writing to stop enrollment prior to the 1st of the month. If I enroll my child in class, I agree to pay a $40 tuition before the 18th of each month for the following month and understand if it is not paid then Katrina's School of Dance will initiate the balance of my account. I further understand that if tuition is not paid before the 19th of the month, my child will be dropped from the class. I understand that Katrina's School of Dance does not send statements for tuition and it is my responsibility to pay my account balance. Class tuition cannot be prorated due to absences. There are no credits or refunds for missed classes, fundraising money raised or costume deposits or costume payments. I understand that costume payments and deposits are non refundable.
YESNO
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Age of Student
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Grade Level of Student
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Birthday of Student
Date
Year
Month
Day
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Name of Legal Guardian #1/Mother
First Name
Last Name
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Phone Number of Legal Guardian #1/Mother
Area Code
Phone Number
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Email of Legal Guardian #1/Mother
example@example.com
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Name of Legal Guardian #2/Father
First Name
Last Name
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Phone Number of Legal Guardian #2/Father
Area Code
Phone Number
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Email of Legal Guardian#2/Father
example@example.com
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Emergency Contact In Case Legal Guardians/Parents are unavailable
First Name
Last Name
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Emergency Contact Phone Number
Area Code
Phone Number
Should be Empty: