*Student's Name
*DOB(mm/dd/yyyy)
*Street Address
*City
*State(XX)
*Zip
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*Home Phone (xxx-xxx-xxxx)
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| * Emergency Phone (xxx-xxx-xxxx) |
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| Cell Phone (xxx-xxx-xxxx) |
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| Work Phone (xxx-xxx-xxxx) |
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| *Email Address |
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| *Person Responsible for Payments |
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| *Payment Plan (A, B or C) |
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| *How do you plan to pay? |
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| Acrobats |
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Tiny Tots |
Day/Time
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Pre Acro (ages 3-4) |
Monday/4:30-5:25 |
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Pre Acro (ages 3-5) |
Tuesday/9:35-10:25 |
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Pre Acro 2 (ages 4-5) |
Thursday/4:30-5:25 |
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Acro 1 |
Day/Time
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Acro 2 |
Monday/6:00-6:55 |
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Acro 2 & 3 |
Friday/6:30-7:25 |
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Acro 3 |
Tuesday/6:30-7:25 |
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Acro 4 |
Monday/7:00-7:55 |
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Acro 5 |
Monday/8:00-8:55 |
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Beginning Cheer |
Saturday/11:30-12:25 |
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Inter/Adv Cheer |
Saturday/12:30-1:25 |
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Tumble Team |
Tuesday/5:30-6:25 |
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| Combo Classes |
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Pre Ballet/Acro (ages 3-4) |
Tuesday/5:30-6:25 |
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Pre Ballet/Acro (ages 3-5) |
Day/Time
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Pre Ballet/Acro 2 (ages 4-5) |
Wednesday/5:30-6:25 |
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Ballet/Acrobatics (ages 6 & up) |
Saturday/10:30-11:25 |
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Pre Tap/Ballet (ages 3-4) |
Monday/4:30-5:25 |
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Ballet/Tap (ages 6 & up) |
Friday/4:30-5:25 |
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| Dance |
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Kinderdance |
Tuesday/4:30-5:25 |
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Pre Ballet (ages 3-5) |
Tuesday/10:30-11:25 |
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Ballet 1 |
Monday/5:30-6:25 |
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Ballet 2 |
Thursday/5:30-6:25 |
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Ballet 3 |
Monday/6:30-7:25 |
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Ballet 4 |
Monday/7:30-8:25 |
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Teen/Adult Ballet |
Thurday/6:30-7:25 |
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Pointe (must be in Ballet 4 too) |
Monday/8:30-9:00 |
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Beginning Clogging |
Thursday/5:30-6:25 |
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Intermediate Clogging |
Thursday/6:30-7:25 |
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Advanced Clogging |
Thursday/8:20-9:15 |
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Dance Company |
Thursday/7:30-8:15 |
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Dance Team |
Thursday/7:30-8:15 |
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Boys Hip Hop |
Tuesday/7:30-8:25 |
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Beginning Hip Hop |
Day/Time
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Intermediate Hip Hop |
Day/Time
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Advanced Hip Hop |
Wednesday/6:30-7:25 |
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Teen/Adult Hip Hop |
Wednesday/8:30-9:25 |
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Beginning Jazz |
Tuesday/6:30-7:25 |
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Intermediate Jazz |
Tuesday/7:30-8:25 |
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Teen/Adult Jazz |
Tuesday/8:30-9:25 |
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Advanced Jazz |
Tuesday/8:30-9:25 |
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Lyrical Jazz |
Wednesday/8:30-9:25 |
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Musical Theater |
Wednesday/7:30-8:25 |
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Beginning Tap |
Wednesday/4:30-5:25 |
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Intermediate Tap |
Wednesday/6:30-7:25 |
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Advanced Tap |
Wednesday/7:30-8:25 |
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By submitting this form, I understand that there is potential for injury with participation in any sport, including classes at Katie’s Dance Studio; and, while at Katie’s Dance Studio, its owners, directors and teachers will make every reasonable effort to eliminate potential for injury, such injury may still occur. I understand this risk and agree to hold Katie’s Dance Studio, its owners, directors and teachers harmless from any and all liability connected with any injury arising out of participation in classes at Katie’s Dance Studio.
By submitting this form, I will abide by the policies and procedures described. I have read, understand and agree with the studio policies, procedures, fees and payment schedule.
*
I have read and fully understand the above agreement. |
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