Wait List Registration 2019-2020 Form -

Student Information

Student's First Name*

Student's Last Name*

Age*

Grade (2019-2020)*

School 2019-2020 (school year)*

Contact Information

Mother's First Name*

Mother's Last Name*

Mother's Work or Cell Phone*

Primary Email*

Father's First Name

Father's Last Name

Father's Work or Cell Phone

Father's Email

Mailing Address*

City*

Zip*

Emergency Contact:*

Relationship*

Emergency Phone Number*

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

Experience

Have you been a student at Elite before?*

Yes
No

What class level?*

Beginner
Intermediate
Advanced

2019-2020 will be my ...*

Other Dance Training*

Please list previous dance training: (include ages/dates and studio name)

Please mark the class(es) you wish to be placed in:

Monday Studio A

3:30-4:15 / 9-11 Jazz A / Sara
4:15-5:00 / 7-8 Jazz A / Sara

Monday Studio B

3:30-4:15 / 7-8 Tap / Shelly
4:15-5:00 / Kinder Jazz / Karin
5:00-5:45 / 10-12 Jazz A / Shelly

Monday Studio C

4:15-5:00 / 9-11 Hip Hop A / Josie
5:45-6:30 / 10-12 Hip Hop A

Tuesday Studio A

4:15-5:00 / 8-10 Ballet / Danie
5:00-5:45 / 10-12 Ballet / Danie

Tuesday Studio B

3:30-4:15 / 7-8 Jazz B / Shelly

Tuesday Studio C

3:30-4:15 / 8-10 Hip Hop A / Josie

Wednesday Studio A

1:30-2:15 / 3.5-5 yr old Pre Dance / Ashley
3:30-4:15 / 7-8 Ballet / Kristi
4:15-5:00 / 9-11 Ballet / Kristi
5:00-5:45 / 9-11 Jazz B / Sara
5:45-6:30 / 8-10 Jazz A / Sara
7:15-8:00 / 10-12 Jazz B / Sara

Wednesday Studio B

3:30-4:15 / Kinder Ballet / Josie
4:15-5:00 / 6-7 Hip Hop / Josie
5:00-5:45 / 8-10 Hip Hop B / Josie
5:45-6:30 / 10-12 Hip Hop B / Josie
6:30-7:15 / 10-12 Tap / Josie

Wednesday Studio C

3:30-4:15 / 6-7 Jazz / Sara

Thursday Studio A

3:30-4:15 / 6-7 Ballet / Ashley
4:15-5:00 / 8-10 Jazz B / Ashley

Thursday Studio B

4:15-5:00 / 6-7 / Shelly

Thursday Studio C

4:15-5:00 / 9-11 Hip Hop B / Josie

Availability

What is the earliest time of the day you can begin classes?*

Example: 3:30pm

School Hours?*

Do you have any additional requests / conflicts?

Yes
No

Conflict / Activity (Be Specific):*

Special Requests:

Additional Family Members

Are you registering an additional family members today?

Yes
No

Student 2 Information

Student 2 First Name*

Student 2 Last Name*

Age*

Grade (2019-2020)*

School 2019-2020 (school year)*

Student 2 Experience

Have you been a student at Elite before?*

Yes
No

What class level?*

Beginner
Intermediate
Advanced

2019-2020 will be my ...*

Other Dance Training*

Please list previous dance training: (include ages/dates and studio name)

Student 2 Please mark the class(es) you wish to be placed in:

Monday Studio A

3:30-4:15 / 9-11 Jazz A / Sara
4:15-5:00 / 7-8 Jazz A / Sara

Monday Studio B

3:30-4:15 / 7-8 Tap / Shelly
4:15-5:00 / Kinder Jazz / Karin
5:00-5:45 / 10-12 Jazz A / Shelly

Monday Studio C

4:15-5:00 / 9-11 Hip Hop A / Josie
5:45-6:30 / 10-12 Hip Hop A

Tuesday Studio A

4:15-5:00 / 8-10 Ballet / Danie
5:00-5:45 / 10-12 Ballet / Danie

Tuesday Studio B

3:30-4:15 / 7-8 Jazz B / Shelly

Tuesday Studio C

3:30-4:15 / 8-10 Hip Hop A / Josie

Wednesday Studio A

1:30-2:15 / 3.5-5 yr old Pre Dance / Ashley
3:30-4:15 / 7-8 Ballet / Kristi
4:15-5:00 / 9-11 Ballet / Kristi
5:00-5:45 / 9-11 Jazz B / Sara
5:45-6:30 / 8-10 Jazz A / Sara
7:15-8:00 / 10-12 Jazz B / Sara

Wednesday Studio B

3:30-4:15 / Kinder Ballet / Josie
4:15-5:00 / 6-7 Hip Hop / Josie
5:00-5:45 / 8-10 Hip Hop B / Josie
5:45-6:30 / 10-12 Hip Hop B / Josie
6:30-7:15 / 10-12 Tap / Josie

Wednesday Studio C

3:30-4:15 / 6-7 Jazz / Sara

Thursday Studio A

3:30-4:15 / 6-7 Ballet / Ashley
4:15-5:00 / 8-10 Jazz B / Ashley

Thursday Studio B

4:15-5:00 / 6-7 / Shelly

Thursday Studio C

4:15-5:00 / 9-11 Hip Hop B / Josie

Student 2 Availability

What is the earliest time of the day you can begin classes?*

Example: 3:30pm

School Hours?

Do you have any additional requests / conflicts?

Yes
No

Conflict / Activity (Be Specific):*

Special Requests:

Additional Family Members

Are you registering an additional family members today?

Yes
No

Student 3 Information

Student 3 First Name*

Student 3 Last Name*

Age*

Grade (2019-2020)*

School 2019-2020 (school year)*

Student 3 Experience

Have you been a student at Elite before?*

Yes
No

What class level?*

Beginner
Intermediate
Advanced

2019-2020 will be my ...*

Other Dance Training*

Please list previous dance training: (include ages/dates and studio name)

Student 3 Please mark the class(es) you wish to be placed in:

Monday Studio A

3:30-4:15 / 9-11 Jazz A / Sara
4:15-5:00 / 7-8 Jazz A / Sara

Monday Studio B

3:30-4:15 / 7-8 Tap / Shelly
4:15-5:00 / Kinder Jazz / Karin
5:00-5:45 / 10-12 Jazz A / Shelly

Monday Studio C

4:15-5:00 / 9-11 Hip Hop A / Josie
5:45-6:30 / 10-12 Hip Hop A

Tuesday Studio A

4:15-5:00 / 8-10 Ballet / Danie
5:00-5:45 / 10-12 Ballet / Danie

Tuesday Studio B

3:30-4:15 / 7-8 Jazz B / Shelly

Tuesday Studio C

3:30-4:15 / 8-10 Hip Hop A / Josie

Wednesday Studio A

1:30-2:15 / 3.5-5 yr old Pre Dance / Ashley
3:30-4:15 / 7-8 Ballet / Kristi
4:15-5:00 / 9-11 Ballet / Kristi
5:00-5:45 / 9-11 Jazz B / Sara
5:45-6:30 / 8-10 Jazz A / Sara
7:15-8:00 / 10-12 Jazz B / Sara

Wednesday Studio B

3:30-4:15 / Kinder Ballet / Josie
4:15-5:00 / 6-7 Hip Hop / Josie
5:00-5:45 / 8-10 Hip Hop B / Josie
5:45-6:30 / 10-12 Hip Hop B / Josie
6:30-7:15 / 10-12 Tap / Josie

Wednesday Studio C

3:30-4:15 / 6-7 Jazz / Sara

Thursday Studio A

3:30-4:15 / 6-7 Ballet / Ashley
4:15-5:00 / 8-10 Jazz B / Ashley

Thursday Studio B

4:15-5:00 / 6-7 / Shelly

Thursday Studio C

4:15-5:00 / 9-11 Hip Hop B / Josie

Student 3 Availability

What is the earliest time of the day you can begin classes?*

Example: 3:30pm

School Hours?

Do you have any additional requests / conflicts?

Yes
No

Conflict / Activity (Be Specific):*

Special Requests:

Monthly fees start September 1, 2019

Please check how you wish to pay:*

I am established as a "Electronic Funds Transfer" (EFT) customer and wish to continue this method of payment for the new dance season using the same account.
I will pay via check or cash.
I wish to pay via EFT, please email the Electronic Funds Transfer Release Form to me.

Student Release Form

Student's Name*

First Last

Student 2's Name*

First Last

Student 3's Name*

First Last

PLEASE READ CAREFULLY AND CHECK EACH BOX*

I understand that tuition is due by the 1st of each month. Tuition can be paid by check, cash, or by Elite’s auto pay service from a checking account. Auto-withdrawal forms will be sent home with confirmation letters in August. Elite does not accept credit card payments.
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. Any classes cancelled by the studio will be made up prior to recital, unless studio is closed due to weather or other natural disaster.
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 so via our add/drop form which is on our website by the 1st of the month in order for the change to take affect for that payment period.
I understand that if my child participates in the spring recital I am responsible to pay a costume fee per class.
I acknowledge and agree that dance training and performing are strenuous physical activities that involve risk of property damage, bodily and personal injury, illness, 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 of 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 (Type name constitutes a signature)*

First Last

Signature*

$35.00 Pre-Registration Fee

The $35.00 pre-registration fee is per dancer. Monthly fees start September 1, 2019. If we are able to place your dancer in a class/classes you will receive an invoice from us for the $35.00 pre registration fee. This fee can not be paid with your monthly EFT tuition withdrawal and you will be asked to mail a check to our studio. (Please note the $35.00 fee is nonrefundable and nontransferable and is NOT part of your first months tuition.)

Medical Information (Please list any important medical information: medications, allergies, limitations/disabilities.)

If you see this message instead of a "submit" button it means you missed checking one of the "Student Release Form" items

Comments

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Wait List Registration for our 2019-2020 Dance Season

Student Information

Contact Information

Experience

Please mark the class(es) you wish to be placed in:

Availability

Additional Family Members

Student 2 Information

Student 2 Experience

Student 2 Please mark the class(es) you wish to be placed in:

Student 2 Availability

Additional Family Members

Student 3 Information

Student 3 Experience

Student 3 Please mark the class(es) you wish to be placed in:

Student 3 Availability

Monthly fees start September 1, 2019

Student Release Form

$35.00 Pre-Registration Fee

If you see this message instead of a "submit" button it means you missed checking one of the "Student Release Form" items