Fall Registration 2016-2017

FALL REGISTRATION 2016-2017

Dancer’s name ______Registration Date ______

School: ______Grade in fall: ______

Home address ______City______Zip Code ______

Dancer’s birth date______Dancer’s age ______(As of 12/31/2016) Mother’s Full Name______Mother’s Cell ______

Father’s Full Name ______Father’s Cell ______

Home phone ______Emergency phone ______

How did you hear about Absolute Dance? ______

Years of experience ______Where did you study? ______

How many Absolute Dance recitals have you been in? ______

We mainly communicate via email. You are responsible to check for updates. Email: ______

I authorize the use of photo images of my child for school brochures or advertising purposes in the sole discretion of Absolute Dance. We will never use student names for advertising without your permission. Are there any known allergies or illnesses we should be aware of? ______Recital 2017 T-shirt Size (included with your registration) XSC SC MC LC SA MA LA XLA XXLA Sizing Kit Available

Please read our studio policy and sign below. You are responsible for knowing and following all policy information. Your registration fee, 1st and 10th tuition payments are due at time of registering. You are responsible for 10 tuition installments. Your spot will not be held without payment and a signature stating that you have read, understand and agree to the conditions of this contract.

Release of Liability: I, as legal parent or guardian of the above student, authorize his/her enrollment in the above classes and release Absolute Dance, LLC of all liability due to personal injury or loss of property. I have read all the Absolute Dance, LLC Policies and agree to abide by the protocol and etiquette requirements. Absolute Dance, LLC reserves the right to modify the terms and conditions at any time, without written notice.

Signature ______Date ______

FOR OFFICE USE ONLY Registration fee: $50 each dancer Monthly tuition: $______Paid: 1st Month $______Paid: 10th Month $______Full Year $______MILITARY Family monthly tuition rate $______DISCOUNT Method of payment: _____Cash _____Check Receipt number ______

Last name on check(s): ______staff initials: _____ date: _____ Other dancers included in this payment: ______Class Schedule: #1______#2 ______#3 ______#4 ______#5______#6______#7______#8 ______#9 ______#10 ______#11______#12______