New Student Registration Form

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Season:_________________________________
Signup Date: _________________________________
New Student Registration Form
Student Information
Student’s Name: _______________________________ Date of Birth (MM/DD/YYYY): ______________
Mailing Address: ______________________________________________________________________
Primary Phone: ________________________________ Phone (2): _____________________________
Name of Person responsible for paying fees: ________________________________________________
Primary Email Address: _________________________________________________________________
Primary Billing Phone # ______________________________
Legal Release and Policy Acceptance (please initial)
___ I/we understand the Studio Policies
___ I/we understand my billing obligations
___ I/we understand the risks related to dance
___ I/we understand my responsibilities for my property
___ I/we understand the dress code
___ I/we understand the schedule
___ I/we give media use rights permission
___ I/we understand the attendance policy
___________________________________
______________________________
Signature / Responsible Party
Date
Classes
Class Name
Meeting Date(s) / Time
Fees / Minutes
Registration Fee:
_______________
Recital Fee:
______________
Tuition:
_______________
Costume Fee: ______________
Discounts:
_______________
Comp Fees:
______________
Total Monthly Tuition
_______________
Gym Fee:
______________
Measurements
____
Height
___
Girth
___ Tights Size
____
Shoe Size
___
Inseam
___ Leotard Size
Medical
Allergies: ____________________________________________________________________________
Will your child require any special medical attention during a normal class: (yes/no) __________________
If yes – Explain: _______________________________________________________________________
[ ] – Recorded [ ] Paid in full [ ] On hold Processed by: ________ Special Notes: __________________
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