All
Tuition, Registration, Recital, and Costume Fees are Non-Refundable
Student's
Name: ______________________________________
Parent/Guardian:
______________________________________
Birth
date: ______________ Age: ___________________
Address:
____________________________________________
City,
State/Zip: _______________________________________
Subdivision
Name: _______________ School: ______________
Home
Phone: _______________ Work Phone: ______________
Cell
Phone: _________________ Pager: ___________________
E-Mail:
______________________________________________
Emergency
Contact Person & Phone:______________________
Has
student had any previous training in dance, gymnastics, or
acting?
Circle:
YES/NO Years: ____ Type: ____ Where studied: ______
DayStar
Dance Academy is not responsible for any loss of clothing,
dance equipment, or any injuries while in class or on the
premises of the studio. NOTE: A thirty (30) day written advance
notice is required upon any withdrawals, as payment is expected.
As
parent or legal guardian, I fully understand all Rules and
Regulations regarding DayStar Dance Academy. Further, I fully
understand the above statement regarding loss or injury and
will not hold DayStar Dance Academy or its staff responsible
for any loss or injuries. By signing this agreement, I agree
to abide by all Rules and Regulations, of which I have received
a copy.
Parent/Guardian
Signature: _____________________________
Date:
________________________
Registering
for: __Summer Camps __Summer Classes __Fall Classes
Class Name: ______________________________________
Class
Day and Time: _______________________________
Amount
Paid $__________ Rec'd by _____________________
ALL
3-4 YEAR OLDS WILL BE PLACED IN CLASSES ON A 30 DAY TRIAL
BASIS.
SELECT
"FILE->PRINT..." FROM YOUR BROWSER TO PRINT THE
REGISTRATION FORM
