THE DANCE STEP 2024-2025 ENROLLMENT & PAYMENT FORM
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Email *
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Student Name *
Student Age *
Additional Student Name(s)
Additional Student(s) Age
Address *
City, State, Zip *
Home Phone
Cell Phone *
Parent/Guardian Name *
Parent/Guardian Phone *
Parent/Guardian Name
Parent/Guardian Phone
Emergency Contact Name *
Emergency Contact Phone *
Please list any known allergies and/or medical conditions (respond N/A if none)
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Please list all medications, dosage and frequency taken by your child (respond N/A if none)
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Payments are due every 4 weeks via Auto Pay. There are no refunds, adjustments or prorating of tuition and fees. Tuition will be processed on the 15th of each month. No places will be held for classes without a card on file.
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Please read carefully. Your child will not be allowed to participate in classes until this release is filled out and received by the studio. The undersigned, being the parent or legal guardian of a minor (“the child”) acknowledges that they have registered the child to participate in a dance/exercise program with The Dance Step (“the studio”). The undersigned further acknowledges that they are aware of no medical conditions of the child which would impair the child’s ability to participate and or which would subject the child to personal injury or illness. In addition, as a term of the child’s participation on behalf of the child, I hereby voluntarily assume all risk of accident, injury, illness and or damage to the child or his or her property. Further, the undersigned hereby releases and discharges the studio, its employees, volunteers, owners and assigns from every claim, liability and or demand of any kind for or on account of any personal injury, illness and or damages of any kind sustained, regardless of the cause. Please confirm with your virtual typed signature.
I authorize TDS to charge my credit/debit card below for recurring monthly class tuition. *
I understand that my information will be saved on file for future transactions on my account. *
A 30-day written notice is required to discontinue the monthly charge above prior to the 1st of the month. I do understand and agree that this monthly tuition will continue until I give TDS a written notice to discontinue. A written notice can be done via email or text. *
Tuition Payments will be processed on the 1st of each month. [Please agree below] *
Please choose the classes you'd like to enroll your child in. (Classes are first come first serve for registration and place will not be held until a credit card is on file.) ALL CLASSES ARE 1 HOUR (except Tiny Tots & Dance & Tumble) *
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Cardholder Name (as shown on card) *
Card Number *
Card Type *
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Expiration Date (mm/yy) *
CVV (3-digits) *
Billing Address Zipcode *
I authorize TDS to charge my card on file when I request for agreed up on purchases such as merchandise or private lessons. [Please agree below] *
A $30 non-refundable registration fee will be processed upon submitting your registration. *
I agree and understand all of the information above. By checking this box and typing my name below, I am electronically signing and consenting. *
Please type your name as an electronic signature *
Date signed *
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A copy of your responses will be emailed to the address you provided.
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