Option 1: Come visit our Studio on 31 Main Street, Marlborough and fill out a Registration form! We would love to meet you in person!

Option 2: Click and download the Word Document, fill out the form and email us at DownTownDanceCenter@gmail.com or come visit our Studio!

Class Registration Form.docx

1 file(s) 55.30 KB

Download

Option 3: Click and download the PDF Document, fill out the form and email us at DownTownDanceCenter@gmail.com or come visit our Studio!

Class Registration Form.pdf

1 file(s) 109.80 KB

Download

Option 4:

Register Online Now!

PART I: STUDENT INFORMATION *

Date of Birth *

School

Female/Male

Grade

Age

Pertinent Medical Information

Class Requested *

Day

Time

I WISH TO ENROLL MY SON/DAUGHTER/SELF IN THE FOLLOWING SESSION(S): CHECK BOX(ES)

Fall Session 1: September 10, 2018 through January 20, 2019
Spring Session 2: January 21, 2019 through June 7, 2019

PART II: STUDENT/PARENT/GUARDIAN INFORMATION Please complete both columns for any information that differs. Please check the box to indicate the Primary Contact. The Primary Contact is the person responsible for payment of this account. All communications including monthly statements will be sent to the Primary Contact. *

Address *

City, State, Zip *

Home Phone

Cell Phone

Work Phone

Parent/Gaurdian

Address *

City, State, Zip *

Home Phone

Cell Phone

Work Phone

Emergency Contact: Whom should we contact in the event of an emergency during class?

Phone

Relationship

PART III: 2018-2019 POLICIES Please read the following carefully. Students will not be permitted to take class until completed. Liability Release and Studio Policies lines must be initialed. Photo Release and Email Permission may be initialed or declined.

Liability Release: While Downtown Dance Center, its owners, and employees, will maintain proper safeguards at all time, I realize that my child will be actively involved in vigorous, physical activities while in class. Downtown Dance Center makes no representations, either expressed or implied, regarding the physical capabilities of a student, although activities are planned to meet the overall requirements of each group or class. I will not hold Downtown Dance Center responsible for accidents or injuries resulting from normal class activities or student negligence.
Studio Policies and Tuition: I have read the Downtown Dance Center Policies and agree to abide by them. I understand that there are three ways to pay tuition. IN FULL, TWO EQUAL PAYMENTS, or TEN MONTHLY PAYMENTS
Photo Release: I authorize Downtown Dance Center to use photographs or video of students listed on page one for promotional and publicity purposes only. Images will not be used for any other purpose.
Email Permission: I authorize Downtown Dance Center to send my monthly e-newsletters and e-statements to the Primary Contact at the email address listed below. Email will replace my regular postal mailings. I will update Downtown Dance Center of any changes to my e-mail address.

Email Address *

Confirm Email

PART IV: PAYMENT METHOD One-Time, Annual Registration Fee: $25.00 for 1 student; $35.00 for 2 or more students. Registration Fee is due at time of enrollment. Please make checks payable to: Downtown Dance Center (see payment schedule below) *

I wish to pay IN FULL for the Entire Season ($75. discount if paid in full before student starts classes – Minimum two hours of class per week)
I wish to pay in 2 EQUAL PAYMENTS ($25. discount for each session taken, if paid in full before session starts– Minimum two hours of class per week)
I wish to pay MONTHLY

PART V: I AGREE TO THE TERMS AND CONDITIONS AS STATED IN THE REGISTRATION FORM *

I Agree

Primary Contact *

Date *

HOW DID YOU HEAR ABOUT US?

Name

Pay Registration Fee Online Now!