The Ridge Academy of Dance

Registration Form

Summer 2015

(Please Print)

Student’s Name:____________________   Age:____  Birth Date:__________

Parent/Guardian’s Name:___________________________________________

Address:________________________________________________________

City:_____________________   State:_____________   Zip Code:__________

Phone Number:____________ Cell:___________ Email:__________________

How did you find out about The Ridge Academy?______________________

________________________________________________________________

Referred by current student:________________________________________

Class/Classes Enrolling In:

Mondays:                                        Wednesdays:

___ 3- 5 yrs. Combo                         ___ 10 yrs. + Interm/Adv Ballet

___ 6-9 yrs. Beg./Interm. Ballet                 ___ 10 yrs. + Interm/Adv Jazz

___ 6-9 yrs. Beg.Interm. Jazz                ___ 8 yrs. + Open Hip Hop

___ 6 yrs. + Cheer Prep                        ___ 4 yrs. + All Boyz Hip Hop

Monthly Tuition Costs:                                                

Hours Per Week

Monthly Tuition Amount

.75

$30

1

$35

1.5

$45

1.75

$50

2

$55

2.5

$65

2.75

$70

3

$75

3.5

$85

3.75

$90

4

$95

Attendance and General Policies:

Safety:

Class Etiquette:

Waiver: I do hereby release The Ridge Academy of Dance, Shauntell Bird, and all other instructors or students in any capacity for any liabilities due to injuries, etc. that my child may obtain while on the premises of The Ridge Academy of Dance or any special event and/or performances associated with the studio. I clearly understand that participation in any classes offered at The Ridge Academy of Dance will involve dance, bodily exercise, and movement with rigorous activity. I am fully aware of my child’s personal medical condition and hereby certify that they are mentally and physically fit to participate in the classes for which they have registered and that I have the medical coverage or personal means to cover the expenses related to any injury that my child might receive as a result of his/her participation. I also understand that I am responsible for the supervision of my child prior to and after class and that it is not permissible to leave my child unsupervised. The Ridge Academy of Dance reserves the right to use photographs taken in class or at performance-related activities for promotional reasons. Lastly, I understand that dance education at times requires “hands on training” in which an instructor may gently touch a dancer’s body to explain proper alignment, positioning, or engagement of muscles.

By signing this registration form, it is acknowledge that I, the parent/guardian of __________________________ have read the list of Studio Rules and Policies as well as the Release Waiver provided and in understanding my personal responsibilities I hereby give my child permission to participate.

________________________      __________________________      ________

Parent/Guardian Name               Signature                                          Date

Office Use:         Registration Fee Paid:  Y / N         Cash / Check No. ______