SUMMER 2012
DANCE MACHINES DANCE STUDIO, INC.
*** REGISTRATION FEE - $20.00 PER STUDENT ***
($50.00 REGISTRATION IF YOU ENROLL FOR FALL)
(New Students only --- Fall 2011-2012 students, no registration fee applies)
 

DATE________ STUDENTS NAME_________________________________________

AGE_________  DATE OF BIRTH_____________  SCHOOL GRADE______________

PARENTS NAME_______________________________________ DL #____________

ADDRESS_________________________________ CITY____________ ZIP________

HOME PHONE ______________________ CELL PHONE ______________________

EMAIL_______________________________________________________________

EMERGENCY NAME & #_________________________________________________

CLASS REGISTRATION

COMBINATION ________ (tap and ballet) AGES 2- 6     JAZZ________   TAP________

BALLET/POINTE________    LYRICAL________  HIP HOP_________ 

CHEER/GYMNASTICS_______   TECHNIQUE_______   CREW ______

MONTHLY TUITION

*****$10 LATE FEE APPLIES AFTER THE 15TH OF THE MONTH *****

1ST CLASS (PER CHILD).....$50.00                               ADDITIONAL CLASS.....$30.00

$200 PER CHILD UNLIMITED

All registration fees and monthly tuition are NON REFUNDABLE! Classes will not be prorated due to absences! Insufficient enrollment in a class may result in the cancellation of a class, in such case, Dance Machines agrees to offer you an alternate class. I hereby release and hold harmless Dance Machines Dance Studio, Inc, its owners and all employees from all liabilities, suits, claims, and/or demands of any kind or nature, legal or financial, whether caused in any way by negligence or participation in any activities. The student named above does voluntarily participate in Dance Machine Dance Studio, Inc and I understand that certain risks are inherent to and from participation and involvement in various activities. Dance Machines Dance Studio, Inc. is not responsible for any lost or stolen property, at any time.

SIGNATURE OF PARENT OF GUARDIAN