Yazoo City School of Dance Registration: 2019-2020 Dance Classes
Dance Classes begin on September 10 & 12, 2019
Studio Location: Triangle Cultural Center- 332 N. Main Street Yazoo City, MS 39194
Contact Director, Krista Bower, at 810-623-4695 or krista.bower@gmail.com with any questions
PLEASE COMPLETE A SEPARATE FORM FOR EACH CHILD REGISTERING FOR DANCE CLASS.
Email address *
Student's Last Name *
Your answer
Student's First Name *
Your answer
Parents' / Guardians' Name(s): "FirstName(s) LastName" *
Your answer
Street Address or P.O. Box # *
Your answer
City *
Your answer
Zip Code *
Your answer
Primary Cell Phone Number xxx-xxx-xxxx *
Your answer
Secondary Cell Phone Number
Your answer
Student's Age *
Your answer
Class Selection *
Required
Liability Waiver: While Krista Bower, Andrea Knudson and any other Faculty/ Employee will maintain proper safeguards at all times, I realize that my child will be actively involved in physical activity while in class/es. Parents, legal guardians of minors, students, and adult students waive the right to any legal action for any injury sustained on the school property resulting from normal dance activity or any other activity conducted by the student before, during, or after class time. If a student is injured or is suffering from a specific condition, it is the student’s responsibility to notify the teacher before the class begins. I have read and agree to the POLICIES AND PROCEDURES listed on the "STUDIO POLICIES" tab of the website. *
Student Medical Conditions / Allergies?
Your answer
My Payment Plan: The $25 Registration Fee (per family) + September's Tuition is due by the 1st day of class. If a student registers for more than 1 dance class per week or if multiple family members register for classes, you will receive a 10% discount on monthly tuition. *
Required
A copy of your responses will be emailed to the address you provided.
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