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Artistry in motion registration form - student information
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Indicates required field
Name
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First
Last
Date of Birth
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MM/DD/YYYY
Age
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Mailing Address
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Phone Number
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City, State, Zip
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Cell Phone
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Email
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Work/Cell Phone
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In case of emergency
Contact Person
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Phone
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Relation
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Contact Person
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Phone
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Relation
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Confidential - Personal Information that the studio/instructor should be made aware of (asthma, seizures, etc)
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Waiver of Injury and Tuition schedule contract
I hereby waive all claims for injury, damage, or loss to my child/self and property at or through participation in classes, rehearsals, or performances at Artistry in Motion, Inc. I release the owners, directors, contractors, and employees of Artistry in Motion, Inc. for any liability for injury or loss by any of the above. I agree that dance and cheer are physical sports and are taken at my child/self own risk, and accept responsibility upon registering my child/self for classes. In cases of medical emergency, I authorize the said studio, its agents, and employees to get treatment for my child/self. The studio will make every attempt to contact parents or emergency names before any paramedics are called.
Accept Below
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Disagree
Accept
I give permission to allow any dance photos of my child/self to be used for publicity or display without prior approval now or in the future.
Accept Below
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Disagree
Accept
On completion of registration, I/my child agree to commit to the class(es) and tuition listed above for the September-May season. To cancel this contract or change classes, I/my child further agree to do so in writing with a Student Drop Form and the required $15 Drop Fee no less than 15 days before the first of the following month or I/my child will be charged for the next month's tuition. I also acknowledge that tuition is due the 1st of every month. Late fees will apply as follows: after the 10th, a $10 late fee will apply; for every 5 days subsequent, ANOTHER $5 late fee will apply.
Failure to pay fees may result in class suspension or collection services.
By signing below, I/my child understand and agree to abide by the contract and studio policies.
Type your full name below to sign
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Check below to signify Initialing
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I accept and Acknowledge the Drop Fee
Check below to Signify Initialing
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I accept and acknowledge the late payment fees
Submit
Home
About our Staff
Our Mission Statement
Class Schedule
Competition Teams
Genres/Classes