PAT’S DANCE STUDIO REGISTRATION FORM

           2009-2010 Season

For Early Registration, fill out form below , enclose check and mail to Studio. Notification of childs’ dance schedule

 will be available by August 1st. (need one month tuition & registration fee)-see below

                                                                                                           

STUDENT NAME:   FIRST__________________  LAST: ____________________________

 

PARENTS NAME:    FIRST__________________  LAST: ____________________________

 

STREET _________________________________Email Address: _______________________

 

CITY ____________________ STATE ___________ ZIP ______________

 

DATE OF BIRTH _________  AGE ____  HOME PHONE _____________  CELL # ____________

 

WORK # ___________EMERGENCY # _____________How did you hear about us?___________

 

PREVIOUS DANCE SCHOOL EXPERIENCE __________________________________________

 

(Classes per child)                    (Registration fee- 1 child $15.00, second $10.00, third or more - free)

one class- $47.00         three classes - $92.00 (3rd class free)         five classes - $144.00

two classes- $92.00      four classes - $122.00                                  six classes - $162.00

Hip hop is not included as a free class; when taking more than 2 classes it will be discounted/$33 per month

 

CLASS 1_________________CLASS 4___________________Class 7___________________

 

CLASS 2_________________CLASS 5 ___________________Class 8 __________________

 

CLASS 3 _________________CLASS 6___________________Class 9 __________________

 

The following information is contained in our Brochure, please read and sign.

1. No checks will be accepted after the 10th payment.              8.Students not attending rehearsal will not be permitted to

2.Tuition and Registration Fee is Non-Refundable                 perform.

3. For tuition past due one month or more (see brochure #5)     9. Child constantly left in studio for more than 15 minutes before

4. $30.00 return check fee                                                                                   or after class will be charged a fee

5. All Balances are due by May 1st.                   .               10. Holiday/Inclement weather will be posted. Call Studio.

6. Food not permitted in building. No gum chewing in class.   11. Insurance -case of injury student must be covered by their

 7. Students scheduled to perform in recitals, must dance.            own family  insurance

       in shows

 

            PARENTS SIGNATURE: _______________________________ DATE: _______________

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(Office use only)                                                                                                                                

 Tuition _______ shoes: ______Total ________ Check/Cash/ Charge(Master/Visa)____________

 

Registration fee: _______Clothes: _______Video ______  Class Codes _____________________   

Plan ________