Broome County Dance Center 2020-2021 Registration
Please complete the following form to register for our 2020-2021 dance season. After you have submitted the form, you will be notified of your schedule and individual information via email.

Please understand that in an attempt to comply with new state and federal COVID-19 protocols, class days and times may be slightly altered. Private lessons will be provided on a first-come, first-serve basis.

We encourage you to visit our website at for our individual class pricing and additional information, including our updated COVID-19 Policy and Mission Statement.

For any further questions, please feel free to email us at We look forward to sharing our 11th dance season with you!
Email address *
Registration Date (to be filled out by office staff)
Student Name *
Parent / Guardian (if dancer is under 18)
Street Address, City, State, Zip *
Home Phone *
Cell Phone *
Birthday *
Previous Dance Experience (# of Completed Years) *
Emergency Contact (Name, Relationship, & Phone #) *
I am interested in the following dance classes *
Individual Responsible for Paying Monthly Tuition for 2020-2021 Season *
I understand that tuition is due by the first week of every month. Failure to pay may result in suspension of classes. *
For your convenience, BC Dance Center will now be accepting Venmo and PayPal for monthly online payments. Please check below if you are interested in these options.
I understand that one (1) dance costume on average costs $120.00 and is NON-REFUNDABLE. This cost DOES NOT include performance tights, a recital t-shirt or shoes. *
I understand that a non-refundable one-time $20.00 registration will need to be paid prior to taking class. *
Additional Comments
ACKNOWLEDGMENT OF RISK AND WAIVER OF LIABILITY - As a condition of use of Broome County Dance Center, LLC and any of ReRent Property Management or UIP’s facility or property, or participation in any class or activity, you agree as a participant or parent / guardian of a participant in the dance studio to assume all risks and hazards of engaging in, spectating or spending time of any sort at the facility, including assuming all risks for personal injury, illness and property damage. You further agree to hold harmless Broome County Dance Center, LLC, ReRent Property Management, their staff, instructors, volunteers, contractors, officials, sponsors, partners or representatives from any liability for any losses, damages or injuries that may occur in any way as a result of these activities or facility uses- regardless of cause. You further certify that you are properly prepared to engage in any activities you have selected. You also agree to abide by the posted health and safety requirements at the facility. You further agree that there is risk associated in regard to the COVID-19 pandemic and possible exposure. Therefore, having read and understood this waiver and in consideration of your accepting my entry into Broome County Dance Center, LLC, I, for myself and anyone entitled to act on my behalf, waive and release Broome County Dance Center, LLC, ReRent Property Management, and UIP all staff, instructors, volunteers, contractors, officials, sponsors, partners or representatives from all claims or liabilities of any kind arising out of my participation in (or as a spectator of) any activity or use of the facility. NOTE: If a participant or facility user is under 18 years of age, you as a parent or legal guardian, agree to the same terms, conditions and waiver of liability set forth in this agreement. By checking the box below, you agree to these terms and conditions. *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy