Dance Student Registration

Dance Student Registration

The perfect registration form for dance studios or schools along with payment option Form Preview
Dance Student Registration
  • Student Registration

    Please complete in its entirety.
    • Parent | Guardian | Person Financially Responsible  
    • Contact Information

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    • Transportation Permission for Students

      "Company or Organization" allows students Age 7 and up the opportunity to learn outside of the studio and to enter the community. Various types of transportation will be available to access community resources. Trips taken by the entire group will use cars, vans and/or buses. Smaller groups may use private or chartered vehicles.
    • Student's Information  

    • Medical History

      Please answer all questions. Your answers will remain confidential.
    • Additional Sibling ( only complete if siblings are registering)  

    • Medical History

      Please answer all questions. Your answers will remain confidential.
    • Liability Clause & Release  
    • PLEASE UNDERSTAND THAT "YOUR COMPANY" TAKES THE FINANCIAL RESPONSIBILITY OF A FAMILY’S TUITION AND PERFORMANCE FEES VERY SERIOUSLY. STUDENTS WILL NOT BE ALLOWED TO PARTICIPATE EITHER IN CLASS OR IN PERFORMANCES IF TUITION AND/OR PERFORMANCE FEES ARE NOT PAID-IN-FULL --EVEN IF OTHER NON-REFUNDABLE FEES WERE PAID. OVERDUE OR UNPAID BILLS WILL BE TURNED OVER TO A COLLECTION AGENCY.

      Additional Required Academy Fees

      *These are fees that may be required

      We will inform you of additional fees required as needed. These fees come up when we are preparing for performances, productions, workshops and trips. We will host fundraisers to offset some of these cost. In the event that fundraisers are not successful, parent are expected to pay in full.

      Student/Parent's agrees to defend, indemnify and hold harmless YOUR COMPANY, its agents, representatives, staff, officers and directors from all damages, including attorneys' fees and litigation expenses (specifically including YOUR COMPANY's attorney's fees and litigation expenses reasonably necessary to successfully enforce this indemnification provision against Student/Parents ), resulting from or relating to any claims, actions, suits or proceedings in law, equity, or otherwise whether in negligence, tort, contact or otherwise asserted against YOUR COMPANY, its agents, representatives, staff, officers, and directors, which arise out of or result from student performance, sales, marketing or any Student/Parents activities on YOUR COMPANY premises or scheduled performances. YOUR COMPANY agrees to defend, indemnify and hold harmless participant(s), its agent, representative, staff, officers and directors from any damage, claims, action suits or proceedings in law equity or otherwise whether in negligence, tort, contract or otherwise asserted against Student/Parent(s) which arise out of or as a result of YOUR COMPANY's actions or negligence, employee actions, and facility or equipment failure, which are reduced to final judgment or settled with YOUR COMPANY's consent.

      PUBLICITY AND PROMOTION RELEASE:

      Student/Parent(s) hereby grants to YOUR COMPANY, its subsidiaries, affiliates, licenses, successors and assigns, the right to use student's name, voice, musical renditions and Dancer likeness, image and picture for any lawful purpose whatsoever. Student/Parent hereby waives any right to inspect and/or approve the finished product or the advertising copy used in connection therewith. Student/Parent(s) also hereby releases, discharges and agrees to save and hold YOUR COMPANY harmless from any liability whatsoever (including but not limited to reasonable attorneys fees and costs expended by YOUR COMPANY to enforce this or any other provision of this Release) by reason of any blurring, distortion, alterations, optical illusion or use in composite form, whether intentional or otherwise, that may occur or be produced in the taking of said pictures or recordings or in any processing thereof, or in the completion of the finished product.

      MEDICAL/PHYSICAL FITNESS/INJURY RELEASE

      A. It is the desire of the undersigned student attend dance classes at YOUR COMPANY.

      B. It is the desire of YOUR COMPANY and the staff and instructors at YOUR COMPANY to provide the dancer with the finest dance instruction available.

      C. The student and the dance instructors are aware that dance is a very stressful, demanding and athletic art form, and that injuries both of a minor and serious nature can and do result. It is necessary for the Dancers to realize that they are assuming a known risk of injury in pursing instruction in dance.

      D. It is the desire of both the Student/Parent(s) to release YOUR COMPANY from any and all liability for damages and injuries received as the result of attending such dance instruction.

      E. It is the Student/Parent(s) responsibility to report any injuries to instructors.

      F. It is the desire of the Student/Parent(s) and the dance instructors that the student maintains a physically fit and healthy lifestyle in efforts to promote the mentee in his/her dance education and training.

      WHEREFORE, the undersigned, for themselves, their heirs, administrators and assigns (hereinafter referred to as "releaser"), grant and agree to fully and forever release and discharge the YOUR COMPANY and its agents, staff, representatives, successors, assigns, ad insurers (hereinafter called "releasee"), from all claims, demands, damages, actions and rights to actions which releaser now hereafter may have arising out of, in consequence of, or on account of all injuries to persons, including any latent injuries, and all developments and results there from, known or unknown injuries, whether developed or undeveloped, and anticipated or unanticipated consequences of all such injuries, illnesses, diseases, losses or damages resulting to Releaser from attending such dance instruction.

    • Clear
    • Register  
    • An administrative fee of 3% has been added to your total at checkout.








    • Subtotal:   $ 0.00 Tax:   $ 0.00 Total:   $ 0.00
    • Click "submit" below. (You may wish to copy/paste your responses in a word processor in case your connection is lost during the submission process. Or you can also print your completed form.)

      If you have any problems submitting your application, please contact us

      Thanks!

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