Dance Unlimited Registration Form Fall 2012
STUDENT REGISTRATION INFORMATION
NAME
BIRTHDATE
AGE as of 9/1/12
GRADE ENTERING Sept '12
SCHOOL ATTENDING
Did you attend DU last year?
Please list all prior dance/acting experience
(if new to DU)
HOME ADDRESS
CITY, STATE, ZIP
EMAIL ADDRESS
Does this student have any medical conditions we should be aware of?
If yes, please explain
Does this student wear glasses?
CLASS SELECTIONS
Please fill in your CLASS NAME / DAY / TIME
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Class/Day/Time
Parent/Guardian Information
NAME
Relationship to student
EMAIL ADDRESS (required for news & updates)
Cell #
Home #
Work #
Tuition Information
-First payment: A minimum of 50% of the first quarter tuition is due to secure your spot. Before clicking SUBMIT below, please select to either send payment by check to 244B South Jefferson St, Frederick, MD 21701 OR have our office staff call you for credit card payment. You will receive a confirmation email once your registration form and deposit have been received. Balance is due prior to the first class, along with the $25 registration fee (for new students).
Successive tuition payments are due as described in the tuition schedule (see Rates & Policies page). Students who have not remitted tuition by the 1st class of the quarter in which tuition is due will not be permitted to take class.
-TUITION AND REGISTRATION FEES ARE NON-REFUNDABLE. EXCEPTION: Tuition will be refunded for medical reasons only (excluding nonrefundable fees and deposits) and only with a doctor’s note. Refund due to medical reasons only will be tabulated from date written notification is received at the Dance Unlimited Office and a $20 processing fee will be charged.
-Unless made at Director’s request, class schedule transfers, drops or changes may be made only at the start of a tuition dance period and are subject to a $20 processing fee.
-PAYMENT OPTIONS: Tuition payments can be made by Visa, Mastercard or Discover. To receive a discount, you can pay with check or cash (a $25 fee applies for any returned checks)
-I understand that there is a $20 late fee charged to my dance account if tuition is not paid by the first of the following month after quarterly tuition is due.
General Information
Policies and procedures included in the current Dance Unlimited Studio information and the Policy Guide and Tuition Schedule & Calendar apply unless otherwise noted within this registration form. It is the responsibility of the parent/student to read and understand these policies and procedures. Students are accepted with the understanding that they have enough self-control to work as part of a group and will adhere to studio policies. Students are expected to behave respectfully in class and on the premises toward teachers, staff and other students and families. Rudeness, lack of discipline, and/or disruptive behavior by any student/family member will be cause for immediate expulsion from the program. Dance Unlimited reserves the right to dismiss any student from the program without refund due to poor attendance, disorderly conduct or inappropriate behavior on the part of the student or any family member. Visitors/Observers are not allowed in classes except during twice yearly Observation Weeks.
Recital for the 2012-2013 season in Sunday June 9, 2013 and Monday June 10, 2013.
I understand that dress rehearsal on June 8, 2013 is mandatory. No exceptions
General & Medical Release
I, the above registered student or parent/guardian of the above registered student, do hereby give permission for the student to participate in activities/events/classes sponsored by Dance Unlimited, Incorporated. I understand and agree that this participation is at our own risk. I acknowledge that by attending and participating in these activities these is a possibility of physical illness or injury to myself/child/ward. I do hereby waive, release and forever discharge any and all rights, and claims for damages, for myself and others who might have a similar claim, arising now or in the future against Dance Unlimited Inc., its owners, operators, instructors, agents or representatives, and associates including, but not limited to, the Performing Arts Factory andOther Voices, Inc., for any and all damages that may sustained while participating in such activities/events/classes/performances. I authorize Dance Unlimited and/or its representatives/associates to use photographs and/or videos of above-registered student, taken in conjunction with classes, performances and events in its and its associates advertising, public relations and/or promotions.
By clicking SUBMIT, you are agreeing that you have read and understood the above Tuition Information, General Information and General & Medical Release and that you agree to the terms and conditions. You also are agreeing to pay a minimum of 50% of the first quarter tuition now in order to secure your spot - balance is due prior to the first class (see payment options above)
