Marissa’s Dance Studio - Annual Registration
1051 S 500 E Orem
702-305-2461
Marissasdancestudio@gmail.com 
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Child’s Name: *
Both Parents/Guardian’s Names: *
Both Parents/Guardian’s Email: *
Both Parents/Guardian’s  Phone: *
Mailing Address: *
Emergency Contact: *
What classes will you or your child attend? *
Participants birthdays: *
Participants clothing sizes: *
Dietary restrictions or allergies: *
Something Teacher Marissa should know about your child:
In the event you are unable to reach me, in the case of accident or injury, I give my permission for treatment as deemed necessary by staff or emergency personnel.   *
Required
I understand that Marissa’s Dance Studio is not responsible for any injuries and that I am to provide my own insurance if injuries occur: *
Required
I have read all studio information and policies including registration/monthly fees, recitals, bad weather/holiday policies, attendance, class observation and practice wear. I fully understand and agree to abide by these policies. *
Required
Marissa’s Dance Studio has permission to take pictures of my child and use them for marketing purposes online and around the studio:   *
Required
I understand that I will need to pay the drop in fee of $15 or the $50 registration fee via Venmo @marissa-harris or cash/card before or upon arrival to be able to participate: *
Required
What is your Venmo? *
I understand that the full months tuition is due on the 1st even if I plan on leaving the studio mid-month.  I also understand if joined in the middle of the month the pro-rated amount will be due before participation in the class: *
Required
I agree to stay up to date on all show and class information via monthly newsletters: *
Required
I understand that I need to be on autopay to get the monthly discounts MDS offers and to let them know in writing 30 days in advance before the next billing cycle if I will not be continuing classes: *
Required
Sign parents full name here:
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