Wait List Registration Form -

Student's First Name*

Student's Last Name*

Date*

Dancer Wait List Registration

NOTE You will not be charged a $35.00 registration fee unless we are able to place your dancer in class.

Mom's First Name*

Mom's Last Name*

Mom's Email Address*

Mom's Work / Cell Phone*

Dad's First Name

Dad's Last Name

Dad's Email Address

Dad's Work / Cell Phone

Age*

Grade (2021 - 2022)*

School Name*

Mailing Address*

City*

Zip*

2021-2022 will be my ...*

Emergency Contact*

Emergency Phone

This phone number must not match the mother / father / home phone number

Please select the CLASSES you would like to be Wait Listed for:

Monday Studio A

3:30-4:15 / Mon A / (Wait List) 9-11 Jazz A / Sara
4:15-5:00 / Mon A / (Wait List) 9-11 Hip Hop A / Joe

Monday Studio B
3:30-4:15 / Mon B / (Wait List ) 5-7 Tap / Shelly
8:00-8:45 / Mon B / (Wait List) Teen Tap / Shelly

Monday Studio C
4:15-5:00 / Mon C / (Wait List) 5-7 Jazz A / Josie
5:00-5:45 / Mon C / (Wait List) 8-10 Jazz A / Josie
7:00-7:45 / Mon C / (Wait List) Teen Hip Hop / Joe
7:45-8:30 / Mon C / (Wait List) 10-12 Hip Hop A / Joe

Tuesday Studio A
3:30-4:15 / Tue A / *PC I Tech / Shelly
4:15-5:00 / Tue A / *PC 1 Ballet / Danie

Tuesday Studio B
3:30-4:15 / Tue B / (Wait List ) 8-10 Hip Hop A / Joe
4:15-5:00 / Tue B / (Wait List) 8-10 Tap / Shelly

Tuesday Studio C
7:45-8:30 / Tue C / (Wait List) 10-12 Hip Hop B / Joe

Wednesday Studio A
3:30-4:15 / Wed A / (Wait List) 8-10 Hip Hop B / Josie
4:15-5:00 / Wed A / (Wait List) 9-11 Ballet / Ashley

Wednesday Studio B
3:30-4:15 / Wed B / (Wait List) 9-11 Jazz B / Sara
4:15-5:00 / Wed B / (Wait List) 5-7 Hip Hop / Josie
5:00-5:45 / Wed B / (Wait List) 10-12 Tap / Josie
6:00-6:45 / Wed B / (Wait List) 10-12 Jazz / Sara
7:00-8:00 / Wed B / (Wait List) Teen Jazz / Josie

Wednesday Studio C
3:30-4:15 / Wed C / (Wait List) 5-7 Jazz B / Ashley
4:15-5:00 / Wed C / (Wait List) 8-10 Jazz B / Sara
5:00-5:45 / Wed C / (Wait List) 10-12 Ballet / Ashley

Thursday Studio A
2:00-2:45 / Thu A / (Wait List) Pre Dance (4-5 yr old) / Ashley
3:30-4:15 / Thu A / (Wait List) 9-11 Hip Hop B / Josie

Thursday Studio B
4:15-5:00 / Thu B / (Wait List) 9-11 Tap / Shelly

Thursday Studio C
3:30-4:15 / Thu C / (Wait List) 5-7 Ballet / Ashley
4:15-5:00 / Thu C / (Wait List) 8-10 Ballet / Ashley
6:45-7:45 / Thu C / (Wait List) Teen Ballet / Kristie
7:45-8:15 / Thu C / (Wait List) Teen Pointe / Kristi

Total Number of Classes Selected

Schedule Notes

Age/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 I-III = 8th grade and up

Classes Marked A and B 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 Members

Families registering more than one student will need to submit a form for EACH STUDENT

Monthly Tuition Starts September 1, 2021

Please 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 email me a form.

Online via PayPal (additional fee of 2.9%).

Online via Credit Card (additional fee of 2.9%).

Student Release Form

PLEASE READ CAREFULLY AND CHECK EACH ITEM
This is required before you can submit your registration

Student 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, credit card, 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 Elite's #1 priority is providing a safe and healthy place for our students and staff. We will continue to follow all CDC and OHA guidelines. Elite will update all Fall Session Families on the latest health and safety procedures and protocols prior to the start of Fall Classes.
I understand that if the studio has to close due to Covid 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 Information
Please list any important medical information: medications, allergies, limitations/disabilities.

Additional Comments / Requests

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"

Wait List Registration Form