STUDENT REGISTRATION FORM

(please print)

 

Student’s Name_________________________________________________________________________

 

Address_______________________________________________________________________________

                            Street                                                        City                                          State                             Zip

 

Mom’s Name_________________________Cell Phone________________Home____________________

 

Dad’s Name__________________________Cell Phone________________Home____________________

 

Email _______________________________________@_______________________________________

(PLEASE PROVIDE AN EMAIL THAT IS CHECKED OFTEN AS WE USE THIS TO UPDATE YOU ON DANCE EVENTS)

 

Emergency Contact____________________________________Phone #___________________________

 

Student’s Birthday _______________Age________ Grade_______School__________________________

 

What dance classes have you taken before?  How many years?  Where?  _____________________________________________________________________________________

_____________________________________________________________________________________

 

How did you hear about our studio? _________Friend_____Drive By_______Website_______Phonebook

 

We at All That Dance understand our obligation to make sure that all of our students and their parents are aware of the risks and hazards involved in the sport of dance.  By signing this waiver, you are hereby releasing All That Dance and all of its employees from all claims on account of any injury which may be sustained by your child while attending any dance class or event associated with All That Dance.  In signing this waiver, you also acknowledge your responsibility in paying registration, tuition, costume, and or recital fees on time.  You also affirm that you carry proper medical, health and hospitalization insurance which you consider adequate protection for your child and All That Dance. 

 

________________________________________    ___________________________________________

PARENT SIGNATURE                                                      PERMISSION TO USE PHOTO ON OUR WEBSITE

 

FOR OFFICE USE ONLY
Session	Day	Tuition	Costume	Recital fee	Payment	Balance due
Registration fee
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