The Art of Dance Studio - Registration Form

The Art of Dance Studio

Date: __________________

REGISTRATION 2012-13

(One form per family)

Student Name(s):

___________________________________________________

Home #: ___________

___________________________________________________

Work #: ___________

Age(s): _____&______

Birthdate(s): _______________________&_________________

Address: ___________________________________________________________________________________________________

Street . . . . . . . . . City . . . . . . . . . Postal Code

Parent Name(s): _____________________________________________________________________________________________

Please list any concerns the school should know about, i.e. illness, etc. (confidential):__________________________________________

________________________________________________________________________________________________________________________

Previous Dance Experience:

____________________________________________________________________________________________

Type. . . . . . . . . . . . . . . . . . . . . . . . length of Study . . . . . . . . . . . . . . . . . . . . . Teacher

Registering for:

Ballet ____

Tap ____

Jazz ____

Acrobatics ____

Hip-Hop _____

Pre-Dance _____

METHOD OF PAYMENT

**** Due upon registration: September tuition, registration fee and costume deposit(s) ****

Payment is in the form of ten cheques, made payable to "The Art of Dance Studio", post-dated for the 1st of every month (September 2011 to June 2012). NSF cheques will be subject to a $15.00 service fee. If a student withdraws permanently from a class, cheques will be returned with the exception of the one month in progress.

Please expect to pay a total of $50.00 to $110.00 per costume. Those wishing to help make costumes: we are looking for one or more parent to sew/construct for the entire group. If interested, please indicate (yes or no) ________________

THE ART OF DANCE STUDIO, THE OWNER, EMPLOYEES, OR CONTRACTORS SHALL NOT BE LIABLE FOR ANY DAMAGES OR INJURIES TO PERSONS, HOWEVER CAUSED, WHICH MIGHT BE SUSTAINED BY STUDENTS, THEIR FAMILIES, GUESTS OR OTHERS IN OUR FACILITY, OR IN ACTIVITIES WHICH MAY OCCUR DIRECTLY FROM OR INCIDENTAL TO ALL ACTIVITIES OF THIS STUDIO. THE UNDERSIGNED PARENT OR GUARDIAN AGREES TO HOLD HARMLESS AND INDEMNIFY THE ART OF DANCE STUDIO, THE OWNER, EMPLOYEES OR CONTRACTORS, WITH RESPECT TO ANY CLAIMS OF LIABILITY, PAST, PRESENT OR FUTURE, FOR ANY DAMAGE OR INJURY, OR LOSS OF LIFE TO PERSONS, HOWEVER CAUSED.

I HAVE READ THE CONDITIONS OF THIS AGREEMENT AND UNDERSTAND AND AGREE TO THE CONDITIONS SET FORTH HEREIN.

Tuition: (incl. GST)	_____________months x	$____________
Registration Fee: (non-refundable - one per family)	=	$_10.00_____
Costume Deposit: (One per class- $30.00 ages 5 and up/$50.00 ages 12 and up)	=	$____________CD