Unity Dance Studios Student Enrollment Form 2021-2022
Please fill out this form to request your class schedule. Please refer to your student evaluation and recommended class form(s) when selecting classes.

*If the class(es) you have selected are full, you will be contacted by a UDS representative to explore different options.
Email *
Phone Number *
Are you a current student? *
Please write your student name as it appears on your current MindBody account (or the name you will use to create your new student account): *
If you have not created an online account with us through MindBody, please click on the link below:
Please select the location(s) for which you wish to enroll: *
Required
By signing up for classes you are agreeing to participate in fall and spring productions. *Select classes will only perform in 1 show *For special circumstances please communicate with a UDS representative *
Please list the class(es) you wish to enroll in including the CLASS TITLE, DAY, & TIME *
Dancewear Notice | All dress code items can be purchased through our UDS dancewear services. To meet the exact requirements for your class please avoid purchasing through outside vendors.
Please let us know if you need any new dancewear items. Please include your current size (i.e. adult medium leotard, adult large tights, size 5 ballet shoes, etc..) If you are unsure of your class dress code or size, please let us know below and a UDS representative will contact you.
LIABILITY RELEASE
I, THE BELOW STUDENT OR PARENT/Guardian, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING AND/OR VOLUNTEERING IN THIS and all future Unity Dance Events. Including by way of example and not limitation, any risks that may arise from carelessness of Austin Burleson, Alexis Ziarkowski Burleson, staff, teachers, volunteers, Board members, Unity Dance Troupe, Unity Dance Studios or any other Unity Dance Troupe or Unity Dance Studios representative or affiliate, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.
I certify that I am physically fit, have sufficiently prepared or trained for participation in the activity or event, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems, such as diseases and or sicknesses which preclude my participation in this activity or event. I also agree that should a major sickness or disease develop I will be asked to vacate the premises until I am no longer sick or contagious. I agree to stay home and not attend class should I feel any symptoms of COVID-19 including but not limited to fever, cough, shortness of breath, or sore throat. I understand that a live-stream contract for my class(es) is available and that tuition will not be waived or refunded for missing class due to sickness. I acknowledge that this Accident Waiver and Release Form will be used by the Unity Dance Troupe and Unity Dance Studios event holders, sponsors, directors, staff, organizers of the activity or event in which I may participate, and that it will govern my actions and responsibilities at said activity or event. In consideration of my application and permitting me to participate in dance classes, rentals, events, productions, shows, dress rehearsals, fundraisers, Unity Dance Studio or Unity Dance Troupe outings, fundraisers, parties, etc. I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:
(A) I WAIVE, RELEASE, AND DISCHARGE the entities or persons, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Alexis Ziarkowski Burleson and or Austin Burleson, and or any staff or teachers of Unity Dance Troupe, Unity Dance Studios and or Unity Dance Troupe’s Board.
(B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in the above paragraph from any and all claims made as a result of participation in this activity or event.
I acknowledge that Unity Dance Troupe and Unity Dance Studios and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting all dance events coordinated by Alexis Ziarkowski Burleson, Austin Burleson, staff, or Unity Dance Troupe’s Board. I acknowledge that this event may involve the potential for death, serious injury, and property loss. The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, coaches, event officials, and event monitors, and/or producers of the event, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers. I hereby consent to receive medical treatment, which may be deemed advisable in the event of injury, accident, and/or illness during this activity or event. I understand that at this event or related activities, I may be photographed and or videoed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by Unity Dance Troupe or Unity Dance Studios. The accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

TUITION/CANCELATION POLICIES
I agree to pay my tuition monthly in full by the stated due date. I understand that if payment is not received by the 15th of each month a $10 late fee will be applied to my account without prior notification. If payment is not received for tuition and the late fee by the end of the month, I understand that I will be asked to observe my classes.
I understand that when signing up for the Fall Semester, I am also signing up for the Spring Semester, which is considered a yearly enrollment (Summer Semester is a separate enrollment).
I understand that, unless previously discussed with the Studio Manager, one month (four weeks) of consecutive absences will result in my spot being given up to the class waitlist.
I understand that in order to be given qualify for a discount on tuition, I must enroll in auto payment (family and university discounts).
I agree to give a 30-day written notice to info@unitydancestudios.com should I decide to unenroll from classes. I also agree to pay a $40 unenrollment fee when unenrolling from the studio.
I understand that I must submit the “Makeup Class Request Form” in order to attend a makeup class. This form must be submitted to and approved by the receptionist at least one day prior to the make up class. The form is available by emailing info@unitydancestudios.com. I understand that makeup classes will only be given for unforeseen circumstances such as sickness and will not be granted for circumstances under my control such as vacation, conflicting scheduling, etc. For the foreseeable future, due to class caps and the need for social distancing, UDS reserves the right to only offer makeup classes via an ONLINE live stream platform.
I understand that I will be asked to sit during class if I do not have the proper dance attire for the particular class.
I understand that by enrolling in specific classes for the Fall and Spring Semester, I am required to be a part of the Fall and Spring productions. *An official request form for non-participation may be submitted to the Studio Manager should any student need to be exempt from these performances.
I agree to pay an additional registration fee should I be unregistered for failing to pay tuition for three consecutive months. If my account has a balance owed, I understand that it must be paid in full in order to register for a new semester of classes.
I agree to pay a drop fee of $15 per class should I decide to drop any class in which I was previously enrolled.
MEDICAL RELEASE
In the case of accident or injury, I give my permission for treatment as deemed necessary by staff or emergency personnel. I also release Unity Dance Studios, Unity Dance Troupe and its directors, employees and subcontractors of liability in case of injury, sickness or accident incurred to the person signing the bottom of this agreement.
STUDENT CODE OF CONDUCT
As a student of Unity Dance Studios, I agree to abide by the following code of conduct:
To conduct myself in a lifestyle of integrity and honor. Unity Dance Studios abides by the values of Jesus Christ and upholds a Christian worldview and moral code.
To continually act in a manner of love, compassion, and empathy toward my fellow students and teachers. I will seek to find the good in others and expect the same in return. I will not put others down and but will encourage others in all they do.
To dress in a way that is modest and appropriate for dance class and abide by the UDS dress code policies.
I agree to abstain from the use of illicit drugs and/or the abuse of alcohol, and inappropriate physical relationships (heterosexual or homosexual) while on the property of Unity Dance Studios.
I recognize that my actions within the studio as well as in public are representations of Unity Dance Studios, my fellow students, and teachers.
I recognize that I am held accountable to these codes of conduct by the executives, staff, and directors of Unity Dance Troupe, both past and present. I also recognize that I may be asked to leave the studio and all classes with no refund if this code of conduct is not upheld.
I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE WAIVER FORM AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL. Please initial below to serve as your electronic signature. *
Upon submission of this form a UDS representative will be in contact with you to confirm your schedule. You will also receive an invoice for your Registration Fee ($35.00 | $15.00 for additional family members), first month tuition payment, and any new dancewear items requested. Submission of this form does not guarantee a spot in your selected classes. Registration fee must be paid and confirmation from the UDS office must be obtained to guarantee your spot in class. You will also receive a confirmation email when the student is enrolled into Fall & Spring productions. A UDS representative must be notified and official un-enrollment must be documented in order to opt-out of a UDS performance.
If you do not currently have a card associated with your account, we highly recommend uploading your billing information in order to allow touchless payment processing. UDS is now limiting the amount of cash or check money exchanges, and we STRONGLY encourage putting a card on file to minimize risk. You can add your billing information by logging into your MindBody account online.
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