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Dance Class Registration Form

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Dance Class Registration Form 2015/16
Inspirations School of Dance and Fine Arts
Student’s Name ___________________________________________________
Date of Birth (mm/dd/yyyy) ____________________________Age__________
❒ Female ❒ Male
Care card Number_______________________________
Medical Conditions/Allergies_________________________________________
Previous dance experience (what styles, how many years)
________________________________________________________________
Are you interested in being considered for ballet exams? (RAD Students Grade 1
Ballet and up) Please note students must take at least two ballet classes a week in order to be considered
for ballet exam
________________________________________________________________
Are you interested in participating in the year end show? __________________
Students E-mail __________________________________________________
Name of Parents/Guardians _________________________________________
Street address ____________________________________________________
City, Province, Postal Code__________________________________________
Home Phone ________________________Cell__________________________
Parent’s Email____________________________________________________
Emergency Contact Name _____________________ phone________________
We have highlighted the classes your child is eligible to attend
Please circle the classes for which you are registering
Schedule 2015-2016
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Preschool
(age 3-4)
9-11:30 am
Preschool
(age 3-4)
9-11:30 am
Preschool
(age 3-4)
9-11:30 am
Preschool
(age 3-4)
9-11:30 am
Parent and
Tot Creative
Movement
(age 1-3)
3-3:30 pm
RAD Grade
2 Ballet
(age 8+)
3:30-4:30 pm
Preschool
(age 3-4)
12:30-3 pm
Preschool
(age 3-4)
12:30-3 pm
Preschool
(age 3-4)
12:30-3 pm
Preschool
(age 3-4)
12:30-3 pm
Parent and
Tot Creative
Movement
(age 1-3)
9:30-10 am
Mini Ballet
(age 3-5)
10-10:45 am
Mini Musical
Theatre
(age 3-5)
3:15-4 pm
RAD Grade 1
Ballet
(age 7+)
3:45-4:45 pm
RAD Grade 2
Ballet
(age 8+)
3:30-4:30 pm
RAD Grade 1
Ballet
(age 7+)
3:45-4:45pm
Worship
Dance
(age 6-12)
4:30-5:30 pm
Junior Lyrical
Jazz
(age 9+)
4-5 pm
Primary
Musical Theatre
(age 6+)
4:45-5:45 pm
RAD
Pre-Primary
Ballet
(age 5+)
4:30-5:30 pm
Special Needs
Dance
(age 3-7)
5:30-6:30 pm
Primary Tap
(age 6+)
4:45-5:45 pm
RAD Primary
Ballet
(age 6+)
6:30-7:30 pm
RAD Grade 3
Ballet
(age 9+)
6:30-7:30 pm
Junior Tap
(age 9+)
6:30-7:30 pm
Teen Ballet
(age 13+)
7:30-8:30 pm
Teen Lyrical
Jazz
(age 13+)
7:30-8:30 pm
Adult Lyrical
Jazz
8:30-9:30 pm
Teen Tap
(age 13+)
7:30-8:30 pm
Mini Musical
Theatre
(age 3-5)
5:30-6:15 pm
Junior
Musical
Theatre
(age 9+)
5-6 pm
RAD Grade
Tiny Tots
3 Ballet
Creative
(age 9+)
Movement
6:30-7:30 pm (age 2-3)
6-6:45 pm
Teen Musical Special Needs
Theatre
Dance
(age 13+)
(age 8+)
7:30-8:30 pm 6:45-7:45 pm
Adult Ballet
7:45-8:45 pm
Mini Ballet
(age 3-5)
5:45-6:30 pm
Adult Hip-hop
8:30-9:30 pm
Mini Tap
(age 3-5)
5:45-6:30 pm
Adult Tap
8:30-9:30 pm
Please not this schedule is tentative and subject to change.
RAD
Pre-Primary
Ballet
(age 5+)
10:45-11:45
am
RAD Primary
Ballet
(age 6+)
11:45 am12:45 pm
Primary Hiphop
(age 5+)
12:45-1:45
pm
Junior Hiphop
(age 8+)
1:45-2:45 pm
Teen Hip-hop
(age 13+)
2:45-3:45 pm
Registration Fees 2015/16
No registration fee if you register by June 30, 2015!
Registration Fee after June 30 is $25 (+1.25 GST = $26.25) per family
Costume Deposit Due By Nov 1 2015 ($50 per costume)
Tot Classes (age 1-3)
30 min class $25/month (+1.25 GST= $26.25)
45 min class $35/month (+1.75 GST= $36.75)
Mini Classes (age 3-5)
Mini Dance Club (includes 3 classes per week) $70/month (+3.50 GST= $73.50)
45 min class $35/month (+1.75 GST= $36.75)
1 hour class $45/month (+2.25 GST= $47.25)
2 classes $60/month (+3.00 GST= $63.00)
Primary Classes (age 6-8)
Primary Dance Club (unlimited classes) $135/month (+6.75 GST= $141.75)
1 hour class $45/month (+2.25 GST= $47.25)
2 classes $ 75/month (+3.75 GST= $78.75)
3 classes $100/month (+5.00 GST= $105.00)
Junior Classes (age 9-12) or Teen Classes (age 13+)
Junior Dance Club (unlimited classes) $150/month (+7.50 GST= $157.50)
Teen Dance Club (unlimited classes) $150/month (+7.50 GST= $157.50)
1 hour class $45/month (+2.25 GST= $47.25)
2 classes $ 75/month (+3.75 GST= $78.75)
3 classes $100/month (+5.00 GST= $105.00)
4 classes $130/month (+6.50 GST= $136.50)
Adult Classes
1 hour class $45/month (+2.25 GST= $47.25)
2 classes $75/month (+3.75 GST= $78.75)
3 classes $100/month (+5.00 GST= $105.00)
4 classes $130/month (+6.50 GST= $136.50)
Cheques can be made out to: Inspirations School of Dance and Fine Arts
10% off if you pay whole year fee by Sep 30, 2015
Family Discount 10% off additional people registering from the same
family!
Please read and initial the following:
______ In the event a student does not wish to continue classes, a parent/guardian must
give one month notice in writing on the first of the month.
______ There is a $30 charge for any NSF payments.
______ No refunds will be given for missed classes.
_____Inspirations School of Dance observes all statutory Holidays. When possible, students
may attend an alternative class at the teacher’s discretion for classes missed due to statutory
holidays (excluding Christmas Break and Spring Break)
______ Students may attend up to 3 make-up classes per year for classes that they were absent
______ I am aware that proper dance attire must be worn to classes. Failure to wear the
appropriate clothing may result in the student not being allowed to participate for that day
______ Valuables should not be brought to the school or any performances. Inspirations
School of Dance is not responsible for any items lost or stolen at our school or anywhere else.
We recommend that students have their name in their dancewear.
_____Inspirations School of Dance reserves the right to refuse service, or ask any student to
leave the school with or without cause
_____Class selections are subject to approval (Ballet is a prerequisite for Lyrical Jazz)
❒ I acknowledge that [I / my child] will abide by all Inspirations School of Dance and
Fine Arts policies
Signature:_________________________ Date: _______________________
Name: _____________________________
(Signed by parent or guardian if student under 19 years of age).
Photo/Video Consent
I authorise Inspirations School of Dance and Fine Arts to take/use photos and video of
myself/my child for educational or promotional purposes in any type of media, including its
website.
By signing below, I acknowledge and accept the above statement.
Signature:_________________________ Date: _______________________
Name: _____________________________
(Signed by parent or guardian if student under 19 years of age).
Liability Wavier
In Consideration of accepting this registration to provide dance classes for my child/myself, I
herby for myself, my heirs, executors and administrators, waive and release any and all of my
rights and claims for personal injuries or property damages I may have against Inspirations
School of Dance and Fine Arts and its agents or representatives for any/all injuries suffered by
me or any member of my family.
I also accept responsibility to pay fees on time and undertake to pay costume fees for each
costume (the cost of which will be determined upon completion of said costumes).
By signing below, I acknowledge and accept the above statement.
Signature:_________________________ Date: _______________________
Name: _____________________________
(Signed by parent or guardian if student under 19 years of age).
Request for email consent:
Inspirations School of Dance and Fine Arts would like to ensure that we have
your consent to receive electronic newsletters, and updates on school
information.
o Yes, I consent to receiving the above communications to my email
address which I have provided below, and understand that I can
withdraw this consent at any time
Email address:
o No, I do not consent to receiving the above communications to my email address
Name: __________________________________________________________________
Signature: ________________________________________________________________
Date: ____________________________________________________________________
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