Dancers Only Registration

Please select all sessions that apply:

Summer

Fall

Student Name 1

Date of Birth

Age

Student Name 2

Date of Birth

Age

Student Name 3

Date of Birth

Age

Phone

Address

City

State

Zip

Parent/Legal Guardians

Emergency Contact (other than legal guardian)

Medical Conditions

Academic School(s)

School Grade (Dancer 1)

School Grade (Dancer 2)

School Grade (Dancer 3)

How did you hear about us?

Previous Dance School (if any)

Dancer 1 (years of dance & subjects studied)

Dancer 2 (years of dance & subjects studied)

Dancer 3 (years of dance & subjects studied)

SUMMER SESSION: Select all classes of interest

Payment & Tuition Information

Tuition is due by the 1st week of each month. If tuition is paid after the 10th of the month, a $5.00 late fee will be assessed, $10 after the 20th of the month. I understand that tuition is based on a breakdown of 9 monthly payments, we do not prorate for missed days, holidays or inclement weather cancellations. Please review our studio Rules & regulations packet.

I, the below undersigned, do hereby release DANCERS ONLY, LLC, its owner, faculty, and staff from any and all claims for damages or for injuries which may be sustained while participating in any class or event connected with DANCERS ONLY, LLC. I understand that DANCERS ONLY, LLC is in no way responsible for any injuries or damages sustained in or around the dance facility.

I’ve read all of the above information and agree.