Dance Registration 2024-2025 Closed for the season 2024-2025 Registration Form 2024-2025 Registration Student's First Name*Student's Last Name*Date* MM slash DD slash YYYY Time* HH : MM AM PM AM/PM Dancer RegistrationMom's First Name*Mom's Last Name*Primary Email Address (Invoices & Newsletters)* Mom's Cell Phone*Dad's First NameDad's Last NameSecondary Email Address (Copy of Invoices) Dad's Cell PhoneAge*3.5456789101112131415161718Gender*(F)(M)Grade (2024 - 2025)*Pre-KKinder1st2nd3rd4th5th6th7th8th9th10th11th12thSchool Name*Home Mailing Address*City*Zip*2024-2025 will be my ...*Please choose one ...1st Dance Season2nd Dance Season3rd Dance Season4th Dance Season5th Dance Season6th Dance Season7th Dance Season8th Dance Season9th Dance Season10th Dance Season11th Dance Season12th Dance Season13th Dance Season14th Dance Season15th Dance Season16th Dance Season17th Dance Season18th Dance Season19th Dance Season20th Dance SeasonEmergency Contact*Emergency Phone*This phone number must not match the mother / father / home phone numberPlease select the CLASSES you are registering for:NOTE: If the class you want to register for is full, please fill out the Wait List Form found on our home page.Monday Studio A 3:45-4:30 / Mon A / 8-10 Jazz A / Closed (0 spots left) 4:30-5:15 / Mon A / 8-10 Hip Hop A / Joe (1 spots left) (0 spots left) (0 spots left) (0 spots left) (0 spots left) Monday Studio B 3:45-4:30 / Mon B / 9-11 Hip Hop A / Joe (3 spots left) 4:30-5:15 / Mon B / 5-7 Tap A / Shelly (6 spots left) (0 spots left) (0 spots left) (0 spots left) 7:30-8:15 / Mon B / Teen Tap / Shelly (7 spots left) Monday Studio C 3:45-4:30 / Mon C / 5-7 Jazz A / Josie (2 spots left) (0 spots left) (0 spots left) (0 spots left) (0 spots left) (0 spots left) Tuesday Studio A 3:45-4:30 / Tue A / 9-11 Jazz A / Sara (2 spots left) 4:30-5:15 / Tue A / 5-7 Jazz B / Sara (0 spots left) 5:15-6:15 / Tue A / Teen Ballet / Danie (2 spots left) 6:15-6:45 / Tue A / Teen Pointe / Danie (9 spots left) (0 spots left) Tuesday Studio B 3:45-4:30 / Tue B / 5-7 Tap B / Shelly (13 spots left) 4:30-5:15 / Tue B / 8-10 Tap / Shelly (17 spots left) (0 spots left) 6:00-6:45 / Tue B / 10-12 Tap / Shelly (14 spots left) (0 spots left) (0 spots left) Tuesday Studio C 3:45-4:30 / Tue C / 8-10 Ballet / Danie (8 spots left) 4:30-5:15 / Tue C / 9-11 Ballet / Danie (17 spots left) 5:15-6:00 / Tue C / 10-12 Jazz A / Sara (2 spots left) (0 spots left) Wednesday Studio A 3:45-4:30 / Wed A / 9-11 Jazz B / Josie (9 spots left) 4:30-5:15 / Wed A / 8-10 Jazz B / Ashley (9 spots left) 5:15-6:00 / Wed A / Teen Hip Hop / Joe (9 spots left) 6:00-7:00 / Wed A / Teen Jazz / Josie (8 spots left) 7:15-8:30 / Wed A / Adv Tech (12 & up) / Josie (5 spots left) Wednesday Studio B 3:45-4:30 / Wed B / 8-10 Hip Hop B / Joe (1 spots left) 4:30-5:15 / Wed B / 9-11 Hip Hop B / Joe (5 spots left) 5:15-6:00 / Wed B / 10-12 Jazz B / Josie (8 spots left) 6:15-7:00 / Wed B / 10-12 Hip Hop / Closed (0 spots left) 7:00-7:45 / Wed B / BOYS HIP HOP (8 & up) / Joe (7 spots left) Wednesday Studio C 3:45-4:30 / Wed C / 5-7 Ballet / Ashley (2 spots left) 4:30-5:15 / Wed C / 5-7 Hip Hop / Josie (9 spots left) (0 spots left) (0 spots left) 7:15-8:00 / Wed C / 10-12 Ballet / Kristi (11 spots left) Thursday Studio A 2:00-2:45 / Thu A / Pre Dance (4-5 yr olds) / Ashley (8 spots left) (0 spots left) 4:30-5:15 / Thu A / 8-10 Jazz C / Josie (2 spots left) (0 spots left) (0 spots left) (0 spots left) (0 spots left) (0 spots left) Thursday Studio B 3:45-4:30 / Thu B / 8-10 Tap B / Closed (1 spots left) 4:30-5:15 / Thu B / 9-11 Tap B / Shelly (4 spots left) (0 spots left) (0 spots left) (0 spots left) (0 spots left) Thursday Studio C (0 spots left) 5:15-6:00 / Thu C / 9-11 Jazz C / Ashley (10 spots left) (0 spots left) Friday Studio A Saturday Studio A Total Number of Classes SelectedSchedule NotesAge/Grade Level: 5-7 yr olds = Kinder/1st, 8-10 yr olds = 2nd/3rd, 9-11 yr olds = 4th/5th, 10-12 yr olds = 6th/7th, Teen = 12 yrs and up. Classes Marked A, B and C does not indicate level - just notes we offer more than one option at that age/level *Classes are for Elite Company Dancers only Additional Family MembersAre you registering additional family members today?* Yes No Families registering more than one student will need to submit a form for EACH STUDENTMonthly Tuition Starts September 1, 2024Please check how you wish to pay your monthly tuition:* I am a returning customer, please use the EFT "Electronic Funds Transfer" form that Elite has on file. I will pay via check or cash. I wish to set up EFT "Electronic Funds Transfer". Please send me a link to set up withdrawals. Online (additional PayPal fees apply). Student Release FormPLEASE READ CAREFULLY AND CHECK EACH ITEM This is required before you can submit your registrationStudent Name* First Last PLEASE READ CAREFULLY AND CHECK EACH BOX* Select All I understand that tuition is due by the 1st of each month. Tuition can be paid by check, cash, PayPal or by Elite’s auto pay service from a checking account. I understand and agree to pay a $20.00 late fee if tuition is not received or if an incorrect amount is received by the 10th of that calendar month. I agree to pay a $30.00 fee for all NSF checks returned by the bank. I understand there are no refunds/discounts for missed classes and due to size restrictions and reporting guidelines, Elite does not offer make up or drop in classes. I understand that if the studio has to close due to state mandate, tuition will not be adjusted. The nature and length of the closure will determine how the studio will proceed with classes. I understand that the monthly tuition fee schedule is based upon a 4 week average month. There will be some months that have 5 weeks and some that have 3 weeks, but tuition is prorated out for 10 months, September- June, so regardless of weeks per month, tuition fees are the same each month. I understand that any changes (add or drop) of classes must be done on line and by the 1st of the month in order for the change to take affect for that payment period. I acknowledge and agree that dance training and performing are strenuous physical activities that involve risk of property damage, bodily and personal injury, illness (including Covid 19), and assume full risk and responsibility. In permitting student to participate in dance training and performing and any activity ancillary thereto, I hereby voluntarily and absolutely release, discharge, waive and relinquish any and all claims, causes of action, losses, costs, expenses, and/or damages, whether in law or equity, against Sara Anderson, ELITE DANCE STUDIO, LLC, employees, contracted instructors, assistants, and volunteers. I also hereby authorize instructors to obtain appropriate medical treatment for my son/daughter if injury or illness occurs during dance training or performance. I understand that Elite Dance Studio LLC will from time to time produce promotional and other materials, including social media outlets, relating to its programs. I understand that as a participant in and/or a spectator at the Elite Dance Studio LLC we may be included in videos and/or photographs taken during any our events. Therefore, without reservation or limitations, I, in my own behalf and on behalf of the Minor Participant, hereby assign, transfer and grant to Elite Dance Studio LLC the right to photograph and/or record my Minor Participant in advertising and promoting Elite Dance Studio LLC. Adult (over 18) signing student release (typing of name constituted a signed waiver)* First Last Signature*Medical InformationPlease list any important medical information: medications, allergies, limitations/disabilities.Additional Comments / RequestsDancer Registration Fee* Price: I wish to pay my registration fee:* Online (additional PayPal fees apply) Mail a check to us at Elite Dance Studio 4062 NW Saltzman Rd Suite 202 Portland OR 97229 N/A This dancer has already registered and been charged the one time per season registration fee Online Fee* Price: $0.00 Student Registration Total $0.00 After you press the submit button you will get an email confirmation. This will be a review of your information and class selections. If this doesn’t arrive in your email, your form was not submitted correctly.If you don’t see a submit button please make sure you’ve checked all the boxes agreeing to our studio policies in the section above labeled: "PLEASE READ CAREFULLY AND CHECK EACH BOX" Δ
