STARSTRUCK DANCE STUDIO STUDENT REGISTRATION AGREEMENT 2018-19
Student Name: ______Street Address: ______City/State/Zip: ______Date of Birth: ______Age (as of 9/18): ______Grade (as of 9/18): ______Number of years of dance training: ______
Parent Information: Mother’s Name: ______Father’s Name: ______Home Phone: ______Home Phone: ______Cell Phone: ______Cell Phone: ______Email address: ______Email address: ______Emergency Contact (non parent): Name: ______Home Phone: ______Cell Phone: ______
If your child has any medical condition (i.e. allergies, medications, disabilities) please explain: ______
Please list registered class numbers for each day of week: Monday Tuesday Wednesday Thursday Friday Saturday ______
It is very important for parents to be aware of what is expected of our students throughout the dance season. Be sure to read all information in its entirety before signing this agreement.
AGREEMENT: I hereby enroll my child at StarStruck Dance Studio (SSDS) for the “2018-2019 Dance Season” beginning Monday, September 10, 2018 and ending June 2019. I have read and agreed to all policies, terms, and conditions as stated in StarStruck literature including, but not limited to, tuition rates/payments, dress codes, class placement, etc. If I chose to withdraw my child from the program at any time during the dance season, I agree to notify SSDS in writing prior to the beginning of a new month, or tuition for that month will be due. In the event my child withdraws from dance class prior to the start of the dance season, I acknowledge that there are no refunds as a spot has been held for my child. If we ask your child to leave StarStruck for unacceptable behavior, bullying, disrespect or any other reason we deem appropriate, there will be no refunds for tuition, costumes, competition fees, etc. Initial _____
I agree to allow my child to participate in the end-of-year recital and understand that I will have to purchase a costume for each class. Full payment for costumes will be due on December 12th and is non-refundable. If I do not wish my child to participate in the recital, I must notify SSDS in writing prior to December 1, 2018 or I will be liable for any out-of-pocket expenses incurred by the studio. I fully understand the risks inherent in dance activities and release StarStruck Dance Studio and its staff from any and all legal liability and medical costs arising due to any injury incurred during the course of instruction or participation in any SSDS related activities. I release rights to all photos/videos taken in relation to StarStruck Dance Studio for exclusive SSDS use in promotion or advertising. Initial _____
I understand that tuition payments are due the first of the month and that no invoices will be mailed to my home. I also acknowledge that a $10 late fee will be applied to payments made after the 10th of each month. A $35 fee will also be applied to all returned bank checks. After the 2nd returned check, I understand that SSDS will require only cash payments going forward. I also acknowledge that if my account is delinquent more than 30 days and/or my child has excessive tardiness or absences, it may result in my child being ineligible to participate in SSDS recital/performances and/or dropped from dance classes entirely. This decision will be at the discretion of StarStruck Dance management. Initial _____
Signature of Parent: ______Date: ______Signature of Director: ______Date: ______
If paying by credit card, please complete this section:
Name on Card: ______Card Number: ______
Card Type: DISCOVER VISA MASTERCARD Expiration: ______Security ______
Check Check box if you choose to be on the automatic payment option which is deducted the 1st of the month
STARSTRUCK DANCE STUDIO STUDENT REGISTRATION AGREEMENT- Summer 2018
Student Name: ______Street Address: ______City/State/Zip: ______Date of Birth: ______Age (as of 9/18): ______Grade (as of 9/18): ______Number of years of dance training: ______
Parent Information: Mother’s Name: ______Father’s Name: ______Home Phone: ______Home Phone: ______Cell Phone: ______Cell Phone: ______Email address: ______Email address: ______Emergency Contact (non parent): Name: ______Home Phone: ______Cell Phone: ______
If your child has any medical condition (i.e. allergies, medications, disabilities) please explain: ______
Please place a check on the line next to the classes that your child would like to participate in:
Session 1: July 30th-Aug 3rd Session 2: August 6th-August 10th ____ Princess Ballerina Camp (ages 2.5-4) ____ Jazz/Hip-Hop Camp (ages 3-5) ____ Ballet/Lyrical Camp (ages 3-5) ____ Commercial Jazz/Hip-Hop Camp (ages 6-8) ____ Jazz/Hip-Hop Camp (ages 3-5) ____ Commercial Jazz/Hip-Hop Camp (ages 9-12) ____ Multi-Style Camp (ages 3-5) ____ Commercial Jazz/Hip-Hop Camp (teen) ____ Multi-Style Camp (ages 3-5) ____ Multi-Style Camp (ages 6-8) ____ Multi-Style Camp (ages 9-12) ____ Multi-Style Camp (teen) ______4 week Sessions: ____ Ballet/Lyrical Camp (ages 3-5) ____ Acro Camp (ages 3-5) ____ Ballet/Lyrical Camp (ages 6-8 +EDC Minis) ____ Acro Camp (ages 6-8 + EDC Minis) ____ Ballet/Lyrical Camp (ages 9-12+ EDC Petites) ____ Acro Camp (ages 9-12 + EDC Petites) ____ Ballet/Lyrical Camp (teen) ____ Acro Camp (teen) ____ Ballet/Lyrical Camp (EDC Juniors/Seniors) ____ Acro Camp (EDC Juniors/Seniors) ____ Musical Theatre/Jazz Camp (ages 3-5) ____ Tap Camp (EDC Juniors/Seniors) ____ Musical Theatre/Jazz Camp (ages 6-8 +EDC Minis) ____ Musical Theatre/Jazz Camp (ages 9-12+ EDC Petites) ____ Musical Theatre/Jazz Camp (teen)
It is very important for parents to be aware of what is expected of our students throughout the dance season. Be sure to read all information in its entirety before signing this agreement.
AGREEMENT: I hereby enroll my child at StarStruck Dance Studio (SSDS) for “Summer Classes 2018.” I have read and agreed to all policies, terms, and conditions as stated in StarStruck literature including, but not limited to, tuition rates/payments, dress codes, class placement, etc. In the event my child withdraws from classes prior to the start of the session or before the session ends, I acknowledge that there are no refunds as a spot has been held for my child. If we ask your child to leave StarStruck for unacceptable behavior, bullying, disrespect or any other reason we deem appropriate, there will be no refunds for tuition, etc. Initial _____
I fully understand the risks inherent in dance activities and release StarStruck Dance Studio and its staff from any and all legal liability and medical costs arising due to any injury incurred during the course of instruction or participation in any SSDS related activities. I release rights to all photos/videos taken in relation to StarStruck Dance Studio for exclusive SSDS use in promotion or advertising. I understand that tuition payments for summer sessions are due in full prior to the start of classes. If payment is not received at least 2 weeks prior to the start of the summer session, my child’s spot in the class will not be held. Initial _____ Signature of Parent: ______Date: ______Signature of Director: ______Date: ______