registration

Advance Dance Registration Form
Studio Location

Name of Parents
Street Address
City
Zip Code
Home Phone
Cell Phone
Work Phone
Email Address
Name of Student #1
Date of Birth
Age
Grade
School
Dance Experience
Class(es) Registering For
Name of Student #2
Date of Birth
Age
Grade
School
Dance Experience
Class(es) Registering For
Name of Student #3
Date of Birth
Age
Grade
School
Dance Experience
Class(es) Registering For
Medical Concerns
Referred By
Registration Fee


Type your initials in the box to agree to the liabilty waiver below.
Waiver of Liability

I/We, the above signed parent(s) or legal guardian(s) of the student(s) named on this registration form, understand that dance requires physical exertion. It is my/our responsibility to consult with a physician before his/her participation in dance class, productions, programs or workshops, on premises or off. I/We agree to assume full responsibility for any risks, injuries or damages that might occur as a result of participating in activities sponsored by Advance Dance.
 
I agree not to hold Advance Dance, any faculty, employee or volunteer liable for injuries sustained or illnesses contracted while a student of Advance Dance. I have read and accept the policies and waivers, and I understand that I am responsible for timely payment of tuition and agree to pay all costs for collection of any unpaid tuition and fees and any finance charges assessed by Advance Dance. Advance Dance may take photo/videos of students for the purpose of promoting the center, documenting progress and performances. I have agreed to the terms of this document of my own free will.
 
By registering on our website, you are agreeing that you have read and agree to Advance Dance’s policies & procedures.



~ We offer an $8 credit to your account when you refer a NEW student that signs up, so make sure you don't forget to add the name of the friend who referred you in the box above so they receive their credit! ~

You WILL NOT be sent a confirmation email for registering. We will only contact you if something is wrong with your form. If you registration form went through, you will be taken to a "Thank You" page upon completion where you can pay your registration fee if you opted to do so online.

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