2011 thru 2012 Fall Registration Form

Please fill in the following information. Your signature on this registration form indicates your understanding and acceptance of these policies. Please mail or bring your registration form and the $35.00 non refundable registration fee to reserve your spot in class to XTREME DANCE. Please make checks payable to Xtreme Dance Studio. 4932 W SR 46, Suite 1048, Sanford, FL 32771 Phone (407) 330-7002 www.xtremedance.cc

Students Name Parent/Legal Guardian Home Phone Address Previous Dance Training? (circle) YES NO Where

DOB

/ E-mail

Grade

Age

Sex

Work Phone_____________________Cell Phone City Zip For how long? Advertisement (which one) Other

How did you hear about Xtreme Dance Studio? Current Xtreme student Drive By Referred by (name)

Emergency Contact Phone List any allergies or other health problems that you feel should be called to our attention, including food allergies (asthma, knee problems, hearing/sight impairment, medications, foods, etc.) In the event of an emergency I, (Parent/Legal guardian signature) Dancers Primary Health Care Doctor Class 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. By signing this form, I hereby enroll as a member of XTREME Dance Studio and understand that he/she will be considered a member for the entire 2011-2012 school year unless we receive a written notice of withdrawal. I understand that I am responsible for complying with all school policies. I also fully understand the costs involved. LIABILITY WAIVER: Xtreme Dance Studio is not responsible for accident, injury to persons and loss or damage to their property, whether on the premises of the studio or off the premises, or in connection with your classes, training, rehearsals, performances, and travel to and from off premises, rehearsals and performances. It is required that all dance students are covered by their own family insurance policy. I acknowledge that there are risks of injury in participating in these activities and knowingly and freely assume all such risks and hereby release and hold harmless The Xtreme Dance Studio Inc., its officers, agents, contractors, employees, owners, and /or owners and leasers of premises and equipment. Below indicates your understanding and acceptance of all policies and waiver on the front and back of this form. (Please turn page over and read and initial all studio policies)
Parent Signature Print Date Minimum class size is 8 active students. Any less may result in a schedule change or cancellation. Please select a second class option______________________ Please check if you would like to set up automatic payment for your tuition. Yes Please check if you will be participating in our annual Showcase. Yes For Office Use Only Date Cash Receipt # # of Dance Hours Check # Tuition Rate No No (if yes, Fill out form) (if yes, Fill out form) C.C. 1st Month

give Xtreme Dance Studio permission to seek medical attention for my child. Phone Number Day Time Class Length
(office use only)

Payment Received: Reg. Description of Charges Above:

Discounts or Promotions if Applicable Comm./e-mails Auto bill attached ______ Dress Code_______Tuition policies discount/credit, withdrawal) Advertising: yes or no
Staff Member Signature Print

(due dates, late fees, returned chk fees, early

TUITION STANDARDS AND POLICIES (Please Read Carefully and Initial) 1) Registration: There is a non refundable $35.00 registration fee due with your registration form. 2nd child $20.00, 3rd child $15.00.

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Tuition: is due by the 1st of the month and is late by the 10th of the month. WE WILL NOT SEND A BILL. Statements are only sent when your balance is past due. If you are absent on the due date, for your convenience you may mail in your tuition or call it in with a credit card. Tuition Rates: are based on the number of hours of dance classes per student &/or family. 45 min/Hour $55.00, 2 Hours $92.00, 3 Hours $122.00, 4 Hours$146.00, 5 Hours $170.00,6 Hours $187.00, 7 Hours $207.00, 8 + Unlimited single student $227.00, Unlimited Family Rate $227.00, (Add $20.00 for each addition hour over 8 hours.) Late fee: A $15.00 late fee will be assessed on the 10th. If you are on autobill and for any reason your card does not process on the 1st attempt, tuition will be charged at the regular amount (no discount will apply). If not processed by the 9th, the $15 late fee will be applied on the 10th. Autobilling early discount: Registration & 1st month will be charged in the studio (unless we have a current card on file at the time of registering-all annual forms must still be filled out). The early discount only applies if you are set up for autobill. Tuition will be drafted on the last day of the ensuing month. A $5.00 discount will be deducted from your total tuition automatically. The $5.00 discount does not apply to partial months and can not be combined with any other offers. In Studio Early Payment Credits: If you are not participating in autobilling, you will receive a $5 merchandise credit if tuition is paid on the last day of the ensuing month. This will be tracked for you and used towards in-stock merchandise at any time. Merchandise Credits must be used by June of the dance season in which they were accrued. Returned Check: There will be a $35.00 fee for any returned checks and payment must be paid in cash or with a money order.

Withdrawal: Notice must be given in writing/email. No partial month refunds will be given for withdrawals made mid-month. Tuition will cease the 1st of the month following written/email notification. No refunds of tuition/fees will be given for unused partial months. No exceptions. 9) Temporary Withdrawal: Students, who drop out temporarily (1 month or more) will be required to renew at $15.00. Written/e-mail notification is required and will apply to the1st of the month following the notification. 10) Holidays, Vacation, Sick Days: Tuition costs are based on an annual rate, and have been broken into equal monthly payments for your convenience. The same amount is due regardless of holidays, vacations or sick days, etc. (see attendance below) there are NO make up classes for scheduled holiday closings. SHOWCASE (ANNUAL RECITAL) FEES (see Showcase form for fees & payment plan options) 1.) Accounts must be current with a zero balance in order to participate in our annual showcase. 2.) If there is an unpaid balance in your account when showcase costumes are distributed you must bring your account balance current in order to receive your costumes. DRESS CODE POLICIES For your convenience you may purchase your dance attire at the studio. Shoes and dance attire appropriate to class is required. It is important for the safety of the dancer to dress appropriately. If a student comes to dance with out the proper dance attire they will receive notice of improper dress code. Repeated noncompliance may result in the student not able to participate in class and no refunds will be offered. 1.) Ballet: (level 1-3) Pink leather split sole ballet shoes / (level 4-6) Canvas split sole ballet shoes: Pink tights and solid color leotard. No princess slippers allowed. 2.) Tap: (level 1+): Any dance attire. Black hard sole tap shoes.

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Jazz, Leaps and Turns, & Musical Theatre: Any form fitting dance attire. Black slip on jazz shoes. Lyrical: Any form fitting dance attire. Lyrical shoes or jazz shoes. Hip Hop: Comfortable clothing. Sneakers, No Jazz shoes. Acro: Form fitting dance attire. Bare feet. Dancers must wear tights for sanitary purposes. Pre K classes: Any dance attire. Black Patent Leather Tap shoes and Pink Leather Ballet shoes. No princess slippers allowed. Mommy and Me: Any dance attire. Pink Leather Ballet shoes. No princess slippers allowed.

Below applies to ALL classes: 9.) Tights are required under leotards for sanitary purposes. 10.) Wear hair pulled back and secured off the face. Hair in bun or off the neck for Ballet class. Please wear cover-ups to and from the studio-especially older students to maintain modesty. 12.) Inappropriate dance attire will be addressed. 13.) No gum chewing- it can be dangerous! PLACEMENT 1.) Students are evaluated on a personal basis; an entire class does not advance as a unit. 2.) Student placement is made at the discretion of the schools director, and or students teacher and not of the student or parent. It is important in be placed in the appropriate classes to ensure proper progression. ATTENDENCE

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It is important for students to attend class regularly and arrive on time. For the safety of our dancers the beginning warm up is the most important, as it prevents injuries and pulled muscles. If you are going to be absent please inform the front desk. 2.) All classes missed may be made up in a similar class and level within one month of the missed class. No refunds will be offered if you are unable to make up a missed class. ADVERTISING Photos, videos, film or audio recordings taken during XTREME studio events, become the property of XTREME Dance Studio and reserves the right to use those items for marketing, publicity purposes. Your signature below indicates your understanding and acceptance of Xtreme Dance Studios Policies & Procedures as written above. Signature Date:______________________

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