2019 WINTER INTENSIVE | Registration Form
January 14-19, 2019

Mailing Address: PO Box 40405, Saint Paul, MN 55104
Location: 2121 University Avenue West, Saint Paul, MN 55114
education@tudance.org | (612) 605-1925 | www.tudance.org

Registration deadline: January 9, 2018
Please complete all the information required.

Please indicate Level: *
STUDENT INFORMATION
Name: *
Your answer
Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Cell Phone:
Your answer
Email Address:
Your answer
Date of Birth: *
MM
/
DD
/
YYYY
Name of School (if applicable)
Your answer
Do you have a medical condition that we should be aware of? *
If yes, please explain:
Your answer
How did you hear about TU Dance Center? *
PARENT/GUARDIAN INFORMATION
Please fill out this section if student is under the age of 18.
Name:
Your answer
Contact Phone(s):
Your answer
Email(s):
Your answer
EMERGENCY CONTACT
Fill out this section if different than the Parent/Guardian information.
Name:
Your answer
Relationship to student:
Your answer
Home Phone:
Your answer
Cell Phone:
Your answer
TUITION & PAYMENT
All tuition payments are due at the time of registration. Please contact education@tudance.org to inquire about payment plans. Tuition payments are non-refundable once the intensive has started.
Tuition Payment at Time of Registration
Financial Aid and/or Payment Plan
Agreement
Your Registration will be acknowledged with an email confirmation. By typing your name below and submitting this form, you agree that TU Dance and TU Dance's teaching artists are not liable for any injuries sustained or illnesses contracted while attending classes at TU Dance Center and at other places designated by TU Dance Center staff or faculty. You are sending or have made full payment; or if you have requested alternate arrangements, you agree to complete payment by the agreed-upon due date. (PLEASE TYPE YOUR NAME BELOW to confirm your agreement.)
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