Fall Registration Form 2020-21
Classes Begin September 14
Email address *
Additional email addresses in which you would like to receive important information
(use commas to separate email addresses)
Gender *
Birth Date *
Age by October 31 of current year *
Student Last Name *
Student First Name *
List any allergies and/or medical conditions you feel ATJ should be aware of
Street address *
Town *
Zip *
Parent 1 Name *
Parent 1 Phone *
Parent 2 Name
Parent 2 Phone
Emergency Contact Name
(other than above info)
Emergency Contact Number
(other than above info)
Emergency Contact Relation
New Student? *
How did you hear about All That Jazz Dance Studio?
New students only. Did someone refer you All That Jazz? If so, who?
Other studio(s) or gyms attended
Any Prior Dance, Gymnastics/Tumbling, or Cheer Experience?
How many years of each style? What styles of dance?
Can All That Jazz Dance Studio use photos of student for advertisement purposes and social media? *
T-Shirt Size *
Classes of interest *
(asterisk indicates approval required)
A credit will not be issued for any missed classes. Missed classes can be made up in another class of same age (any style) while currently enrolled. *
There is a $20 non-refundable registration fee per student. Monthly tuition is due on the first of every month and will be automatically deducted from the account provided on this form. A 10% late fee will be applied to any outstanding balances not received by the 10th of the month. There will be a $25 fee for any returned checks. Auto withdrawal does not apply to plans B, C and D. *
I agree to read and abide by the All That Jazz student handbook *
This agreement releases All That Jazz Dance Studio, LLC from all liability related to injuries that may occur on premises or during a performance. I agree to hold All That Jazz free from all liability including financial injuries incurred regardless of whether said injuries are caused by negligence. I also acknowledge the risks involved in dancing, cheer and gymnastics. I am participating voluntarily and all risks have been made clear to me. I agree that there are no pre-existing conditions that will increase my likelihood of experiencing injuries while engaging in these activities. I have read the terms above and understand them. I further understand that agreeing to this release, I voluntarily surrender certain legal rights.
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