HTML Preview Dance School Registration Form page number 1.
Below is the registration form for the 2014-2015 dance year. There is a non-refundable registration fee of $15.00
per dancer due with the registration. A $20.00 fee will be charged for late registrations after October 1st
Please see the August Newsletter for more information concerning start date, shoe sale, payment schedule, etc.
One dancer per registration. Dancers must be 4 years old by December 1st to register. Classes are $5.00 per
week per class, see class payment information below.
Dancer Name: Birth date:
Address: Grade 2014-15:
City, State, Zip: Home Phone
Parent Name: Work/Cell Phone:
Email : __________________________________________
Classes: (check class or classes in which dancer will be participating)
8:30-9:30 Dance - Grades 7th and up
9:30-10:15 Acro - Grades 4th and up
10:15-11:00 Special Ballet - Grades 4th and up
11:00-11:45 Dance - Grades 4th - 6th
11:45-12:30 Dance - Pre-K - K (new dancers)
12:30-1:15 Dance - Grades K - 1st (previous dancers)
1:15-2:00 Acro - Grades 1st - 3rd
2:00-2:45 Dance - Grades 2nd - 3rd
CLASS PAYMENTS - (Taken from August Newsletter):
Payments will be due the first week of the month. We do NOT accept
weekly payments…. Payment is due even if class is missed. If you join in the middle of a month, the full
monthly payment will be due. Once payment is made for the month there are no refunds.
PARENT, PLEASE SIGN THE FOLLOWING:
I HEREBY RELEASE LITTLE FLOWER CHURCH, LITTLE FLOWER SCHOOL AND LITTLE FLOWER
LADIES CLUB FROM ALL RESPONSIBILITY FOR ANY INJURIES SUSTAINED BY MY CHILD:
_________________________________________(CHILD'S NAME), WHILE ON SCHOOL AND
CHURCH PREMISES BEFORE, DURING AND AFTER DANCE CLASS. I HAVE ALSO READ,
UNDERSTAND AND AGREE TO THE ABOVE CLASS PAYMENT TERMS.
______________________________________________
SIGNATURE OF PARENT DATE
New Dancer _______ Previous Dancer _______ (check one)
LITTLE FLOWER DANCE SCHOOL
REGISTRATION FORM 2014-2015