Student Name *

Class Names, Days and Times *

List Reasons for Withdrawing or Change of Class *

Teacher(s) was/were cheerful, encouraging, inspiring, prepared, organized, created a safe and supportive environment and was on time. Teacher(s) dress and demeanor was/were appropriate for age and style. Maintained appropriate order and respect. Makes corrections and requests in a clear and professional way? *

Class placement was appropriate for student's age and ability? *

Teacher(s) provided adequate warm up, fundamentals and footwork, strength building and appropriate challenge skill building exercises and drills are evident. Clear explanation of technique Choreography appropriate for age and level? *

Teacher(s) communicated pertinent information, receptive to feedback from students/parents? Teacher/Director are available for phone calls or conferences Important dates and deadlines are communicated in a clear and timely way? *

Office staff is helpful and friendly? The facility is clean and pleasant and Dance Shoppe is useful and convenient? Management team is organized, available and professional? *

What could we have added or provided that would make your participation at Dance Pointe even better? *

Would you recommend Dance Pointe to a friend or family member? If no, please let us know. *

Method of Payment *

Please indicate date you notified Dance Pointe *

Please indicate whether you notified Dance Pointe by *

As stated in Dance Pointe's agreement of which your signed copy is on file, the online parent portal agreement, as well as electronic receipts to discontinue any lessons, 30 days notice prior to the next billing cycle on the 1st of the month must be given. A credit for makeup classes is issued for any unused tuition fees and may be used at any time for any of our programs. Downpayment fees are nonrefundable. Refunds may not be given on any payments that are made for tuition, competition fees, costumes, dancewear, photographs, DVD's, recital tickets, apparel or in advance to hold class placement. Dance Pointe reserves the right to hold any costumes paid for in advance for any unpaid balances. All auto-debit ACH (checks) or automatic debit or credit card charges will be stopped or adjusted as of the following month once this form is received by our accounting department. Please indicate the date 30 days from today's date below. For example if today's date was 1/14/20 the date you would enter is 2/14/20. *

Signature of Parent/Student (Please Type Full Name) *

Thank you for giving us the opportunity to teach your child/children. All our best, Your Teachers at Dance Pointe