REGISTRATION FORM

STUDENT INFORMATION

Student(s) Name *

Student(s) Name

If applicable, list multiple dancers in this space.

First Name

Last Name

D.O.B. *

Age/Date of Birth of all applicable dancers.

PARENT INFORMATION

Parent Name *

Parent Name

First Name

Last Name

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email *

Cell Phone *

Cell Phone

(###)

###

####

Work Phone

(###)

###

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REGISTRATION INFORMATION

Class

Day/Time/Name of Class

Class

Day/Time/Name of Class

Class

Day/Time/Name of Class

TUITION POLICY

IN FAIRNESS TO ALL STUDENTS, THERE WILL BE NO EXCEPTIONS TO THE FOLLOWING TUITION POLICY.

1. MONTHLY TUITION IS DUE THE 1ST DAY OF EACH MONTH AND IS DELINQUENT AFTER THE 15TH. *

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2. A $10.00 PER MONTH SERVICE CHARGE WILL BE AUTOMATICALLY ADDED TO YOUR ACCOUNT IF PAYMENT HAS NOT BEEN RECEIVED BY THE 15TH OF EACH MONTH. AN ADDITIONAL LATE FEE OF $10.00 WILL BE CHARGED IF FEE IS NOT PAID BY THE FOLLOWING MONTH. *

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3. TUITION IS REQUIRED EACH MONTH, REGARDLESS OF ATTENDANCE, UNLESS THE STUDENT DROPS THE CLASS AND INFORMS THE OFFICE. TUITION RESERVES YOUR PLACE IN CLASS. THE REGISTRATION FEE MUST BE PAID AGAIN IF THERE IS A NEED TO RE‐ENROLL. *

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4. TUITION PAID FOR ONE MONTH MAY NOT BE CARRIED OVER AS CREDIT INTO FUTURE MONTHS EVEN IF CLASSES ARE MISSED AND NOT MADE UP. *

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5. THE STUDIO IS CLOSED FOR THE FOLLOWING HOLIDAYS: LABOR DAY, HALLOWEEN, THANKSGIVING WEEKEND, WINTER BREAK, SPRING BREAK AND MEMORIAL WEEKEND. *

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6. MONTHLY TUITION REMAINS THE SAME. STUDENTS ARE OFFERED MAKE‐UP CLASSES FOR THOSE CLASSES MISSED. *

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7. RETURNED CHECKS ARE SUBJECT TO A $15.00 BANK SERVICE CHARGE. *

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8. A $40 COSTUME DEPOSIT IS DUE WITH YOUR NOVEMBER TUITION. THIS DEPOSIT WILL BE DEDUCTED OFF OF THE FINAL AMOUNT OF YOUR DANCER'S COSTUME. NO COSTUME WILL BE ORDERED WITHOUT A PAID COSTUME DEPOSIT. COSTUMES WILL NOT BE RELEASED TO THE DANCER UNTIL YOUR ENTIRE ACCOUNT (INCLUDING FINAL COSTUME BALANCE & SEPT-JUNE TUITION BALANCES) ARE PAID IN FULL.

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AGREEMENT *

I have read and agree to the above tuition policy, as well as, studio rules and dress requirements as shown in the brochure and/or website. I understand that I am responsible for full tuition each month for the class(es) I am registered in. I hereby waive, release and indemnify Danceworks of Miami and their agents, employees and independent contractors from any and all liability and damages in connection with my or my child’s participation in this program.

I AGREE

CREDIT CARD INFORMATION

The following information is required in order to process your registration form. A $25 single student or $45 family registration fee will be charged upon receipt of this form. Registration fee is non-refundable/ non-transferable.

Name (as it appears on the card) *

Name (as it appears on the card)

First Name

Last Name

Billing Address *

City/State/Zip *

Credit Card Number *

Visa/ Mastercard/ Discover Accepted

Expiration Date/CVC *

Please choose the correct fee amount: *

$25 Single Student Registration Fee

$45 Family Registration Fee

PAYMENT AGREEMENT *

I hereby authorize Danceworks of Miami to charge the above registration fee. I understand that this fee is non-refundable/non-transferable and will hold my space in the above registered classes.

I AGREE