"dedicated in helping each dancer reach their full potential in and out of the dance studio"

2019 - 2020 Registration

Registration Form

Register for 2019 - 2020 dance classes below

Adult Name *
Adult Name
Phone Number
Phone Number
Emergency Contact *
Emergency Contact
*if can not reach number above
Emergency Contact Phone Number
Emergency Contact Phone Number
Dancer #1 Name *
Dancer #1 Name
*Oldest to youngest
Birth Date *
Birth Date
enter what class enrolling in for the 2019-2020 season
Dancer #2 Name
Dancer #2 Name
Birth Date
Birth Date
enter what class enrolling in for the 2018-2019 season
Dancer #3 Name
Dancer #3 Name
If more than 3 dancers make add another registration form
Birth Date
Birth Date
enter what class enrolling in for the 2018-2019 season
Tuition Discounts
10% off whole 32 week tuition if paid in full upon registration (80% refund given if dancer drops) $8 off 2nd dancer’s monthly tuition per month $5 off each after 3 or more family members monthly tuition per month $5 off of each extra class dancer is enrolled in per month Acro/Tricks or Stretch class free if enrolled in 3 or more classes per month Boys dance free first year enrolled
Checkbox *
Read and Then Sign Liability Waiver and Acknowledgment of Risk: (registration is not complete without signature) I understand and agree that in participating in any dance class or rehearsal or performance, there is a possibility of physical injury. I voluntarily agree to assume all risks and responsibility for any such injury or accident, which might occur to me, my child, or any person I bring into the space where The Dance Space classes, activities, performances, or rehearsals are held. I also exempt, release, and indemnify The Dance Space, its owners, agents, volunteers, assistants, employees, guests, faculty members, and/or students from any and all liability claims, demands, or causes of action whatsoever from any damage, loss, injury, or death to me, or property which may arise out of or in connection with participation in any classes or activities conducted by The Dance Space. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold The Dance Space, its owners, volunteers, assistants, employees, guests, faculty members, and/or students liable for such loss, injury, or death. I understand that I should be aware of mine and my child's physical limitations and agree not to exceed them. If I am signing this waiver for my children/dependent, I certify that I am the parent or legal guardian and have the right to waive these rights for the names listed above. You also agree to pay each months tuition during the first week of the month in full. A late fee of $25 can be applied to your account if not paid by the 10th of the month. There will also be a $30 charge for any returned checks. All balances need to be paid before the recital. If there is an outstanding balance the dancer will not be able to participate in the recital at the end of the season.
Signature *
Signature
By typing your name below you are agreeing you have read, understood and agree to be bound by the above statement (please print your name, sign, and date below):
Checking this box gives permission is granted to The Dance Space to use photographs or videos of dancers for publicity purposes.
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