DANCE
FX
REGISTRATION FORM
Please complete registration form, read and sign the attached “Rules
and Regulations” contract. Please retain
one copy of the contract for your future reference.
STUDENT’S NAME________________________________________
ADDRESS________________________________________CITY____________________ZIP____________
AGE__________B/DATE_______________SCHOOL____________________________GRADE___________
HOME PHONE_____________BUSINESS PHONE
MOM__________________DAD____________________
PARENT’S NAME
MOM_____________OCCUPATION____________DAD______________OCCUPATION_________________
EMERGENCY NUMBER:
NAME_______________________________PHONE_________________________
MOM’S CELL ___________________DAD
CELL________________EMAIL____________________________
HEALTH
INFORMATION:___________________________________________________________________
PHYSICAL
LIMITATIONS:___________________________________________________________________
DANCE
EXPERIENCE___________YEARS
WHERE__________________________________________
HOW DID YOU HEAR ABOUT
US?____________________________________________________________
A yearly non-refundable registration fee with one month’s tuition is
due and payable at the time of registration.
Registration fees
are:
New Student: $30.00
Existing Student $25.00
Parents are welcome to observe their child’s progress through the
windows at anytime, but we ask that you remain
in the reception area while waiting for class to end.
Please read the “studio guide” for specific information on studio
policy, holidays and rehearsal dates for the coming
year. This handbook will be available at the reception desk the first
week of class.
Thank you for your interest and support of Dance FX Inc. We pledge to
offer your children the best dance education
possible.
As a Parent/Guardian of a Participant in our program, I recognize and
acknowledge that there are certain risks of physical injury and I agree
to assume full responsibility of any injury (including death) damages
or loss which I or my minor child/ward may sustain. I agree to
indemnify and hold harmless any employees, independent contractors from
any and all claims resulting from injuries (including death) damages
and losses sustained by me or my minor child arising out of connected
with or in any way associated with the activities our programs.
SIGNATURE_______________________________________DATE__________________
CLASS_____________________DAY/TIME______________________TEACHER________________________
CLASS_____________________DAY/TIME______________________TEACHER________________________
CLASS_____________________DAY/TIME______________________TEACHER________________________
CLASS_____________________DAY/TIME______________________TEACHER________________________
CLASS_____________________DAY/TIME______________________TEACHER________________________
CLASS_____________________DAY/TIME______________________TEACHER________________________