5 Star Dance & Tumbling Academy

5 Star Dance & Tumbling Academy

Student Registration Form 2019/2020

 

Student’s Name (First & Last): ­­­­­­____________________________________ 

Date of Birth (if under 18):_____________

 

Mailing Address:                                                                                                    

 

City/Town:                                              State:                                 Zip:_______________

 

Home Telephone #:            ________________________________________________________________________

 

Mother’s Name: ___________________________________ Mother Cell #:_________________

 

Father’s Name:  __________________________________________Father Cell #:____________________

 

Name of Responsible Party: _______________________________________________________________

 

If address and phone numbers are different from above please include:

Telephone #: _______________________

 

Street: _________________________________City: ____________State: ________Zip: ___________

 

Email address of primary contact (used for e-mail billing): ____________________________________________________________________

 

 

Please advise us of any medical conditions that may affect the student’s participation:

____________________________________________________________________________________________________________________________________

 

 

Agreement for Participation

 

I understand that dance classes may include, without limitation, dancing with props, stretching, barre work, across the floor combinations, dance routines in the center, and other related activities.  I further understand that all of the activities of the dance class involve some degree of risk of strain or bodily injury.   5 Star Dance & Tumbling Academy is not responsible for personal property. 

 

I have received the student handbook and agree to adhere to all the content stated therein including:

*Studio Policies                         *Tuition & Payment Information                *Dress Code

*Traffic Pattern                          *Visitor Weeks                                                   *Calendar

 

I agree to be responsible for reading studio correspondence and respecting deadlines, if applicable.

 

I hereby acknowledge that I have read the statements above and agree to participate accordingly.

 

Date: __________________________________        Signature: _______________________________________________________

                                                               

 

Please list the class(es) you wish to enroll in.

                                                                                                                                                                             

Style

Age

Days/Times That Don’t Work

 

1.

 

 

 

2.

 

 

 

3.

 

 

 

 please list additional classes below:     SUB-TOTAL: $______________(what your monthly bill will be – not due now)

 

4. _________________________________                         Apparel and Accessories Total:      $_____________

 

5. _________________________________                                                                    SUB-TOTAL:        $       _______

 

6. _________________________________                                                           Registration Fee:        $ ____     

 

7. _________________________________                                                                             TOTAL:       ­­­­­­­­$        _______

 

8. _________________________________                                       Amount  Paid (check number): ­­­­­­­­$        _______

 

                                                                                                                                                   Balance Due:      ­­­­­­­­$        _______

 

                                               

For Office Use Only:

                 #     ______ AB     _____ QBA      _____QBR         _____QBM      _____DBA     _____DBC      _____EM     _____LB

 

 

Participant Waiver/ Code of Conduct

2019/2020

Participant Name__________________________________________________________

Address_________________________________________________________________

Telephone #______________________________________________________________

Parent/Guardian Consent of Participation and Waiver

By submitting and signing this form, I acknowledge that I am aware that there are risks associated with dance and tumbling.  I warrant that the participant named on this information form, is physically fit to be able to participate in dance and/or tumbling.  I declare that I have accurately disclosed all information regarding physical, mental or medical conditions affecting the named participant and acknowledge that this information may be used for my child’s well-being in class.  I acknowledge that there is a potential risk for injury involved in training and competing in any sport.  I understand that 5 Star Dance and Tumbling Academy has tried to create a safe and controlled environment for participation and that the Academy has established rules for participation.  I understand that failure to comply with any of these policies or rules of 5 Star Dance and Tumbling Academy may result in the suspension or termination of membership.  I waive the rights of the participant to damages or other costs in the event injury is caused due to participation in dance or gymnastics or other involvement with the Academy or inside the studio.

I understand that it is my responsibility to ensure that the information on this form is kept current and I will notify the Academy of any changes immediately.

Signature of Participant (or Parent/Guardian if participant is under the age of 18)

X__________________________________________ Date _____________

      

RULES & GUIDELINES  

•                                                            Conduct by your child at all times should respect authority, honesty, as well as courtesy and respect towards others.  If your child misbehaves we have a time-out area where they will sit until they have decided they will listen and would like to rejoin the class. If the child continues to misbehave we will call and ask you to pick up and take your child home.  We have the authority to refuse to teach your child if they are not able to listen and respect our authority.

•                                                            Payments are due in the office by the 10th of every month.  If payments are not made your child cannot participate in class. There is a $10 late fee every month your bill is late or has a late balance on it.  There is a $25 charge for returned checks.  All bill must be paid up by recital in order for your child to participate.

•                                                            NO PLAYING ON MATTS OR DANCE FLOOR AT ANYTIME….unless in class.  I should not have to come out of my office to remind children of this rule. When the child comes to class they need to put their things in a cubby, get ready for class, then go to the floor or a bench or chair amd sit until the teacher begins class.

•                                                            Unless class is cancelled by me you will not be given a discount for classes missed.

•                                                            If you need to talk to me about anything please make an appointment with me outside of class time.

•                                                            2 MINUTE RULE: Classes will end two minutes before time is up and then the next class will start two minutes after.  This gives kids in both classes a total of four minutes to come in or leave and get their things together. You may also come in with your child at this time to help them get ready for class before you leave (good idea for preschool students).

•                                                            Students must wait on stairs until it is time for their class to begin.  Please don’t drop your child off way before their scheduled class so they are not waiting on the stairs for a long time and do not leave your child at the studio for long amounts of time.

•                                                            When your child’s class is over they will wait on the stairs until they either have visual contact of you outside or you come in to get them. (If they are not walking home).

•                                                            When parents are allowed to watch all cell phones must be turned off and it needs to be as quiet as possible during class time.  Please try not to bring your other children to class as it becomes a distraction.

•                                                            All children need shoes by October.  If your child does not have shoes by then they will not be allowed to participate in class until they do.  Also, if your child is dressed inappropriately for class they will not be able to participate.

•                                                            If there are any other rules you are unaware of please read through your registration packet.

 

I understand these rules and will guide myself and my child to understand and abide by them

      Parent Signature:_________________________________________

Child Signature (if available):_______________________________

Date:________________________________________