New Student Registration Form

Print this page and bring it with you to your first class, along with a $20 registration fee.

**You WILL NOT be able to take class if you have not filled out a registration f m!**


Student Information:                  *Each Dancer has their Own Registration Form*


Student’s Name: ______________________________________________________

Date of Birth (MM/DD/YYYY): ____________________________________________

Mailing Address: ______________________________________________________

Primary Phone: ________________________   Please circle best communication method:

Phone (2): ____________________________      || Call || E-mail || Text ||

Name of Person responsible for paying fees: ____________________________________

Primary Email Address: __________________________________________________

Primary Billing Phone # __________________________________________________


Legal Release and Policy Acceptance (please initial)

___ I/we understand the Studio Policies                               ___ I/we understand my billing obligations

___ I/we understand the risks related to dance  ___ I/we understand my responsibilities for my property

___ I/we understand the dress code                        ___ I/we understand the schedule

___ I/we give media use rights permission           ___ I/we understand the attendance policy


Signature / Responsible Party                                                                      Date                           



Class Name Meeting Day (s) / Time Class Total



Registration Fee:       _______________                       Recital Fee:    ______________

Tuition:                       _______________                       Costume Fee:            ______________

Discounts:                  _______________                       Comp Deposit:______________

Total Monthly Tuition_____________          ‘Unlimited’ payment:__________


Measurements (will be taken by instructor)

____  Hips                ___     Girth               ___ Bust                               Shoe Size

____             Waist              ___     Inseam           ___ Leotard Size                  Tight Size





Will your child require any special medical attention during a normal class: (yes/no) ___________________________________________________________________________________________________________________________

If yes – Explain: ____________________________________________________________________________________________________________________________



Please provide two contacts that would be called in case of an emergency at the studio



Phone Number                                                          Relationship to dancer                                 



Phone Number                                                          Relationship to dancer