Allegro
Performing
Registration Form
Please Print
Email____________________________
Date________________ Home
Phone__________________ Cell Phone____________________
Parents Name (last)______________(Mother’s first)____________(Father’s
first)____________
Address_________________________________________City______________Zip__________
Emergency
Contact___________________________ Emergency Phone ___________________
Students Name (last) _____________________ (first) _____________Age ____DOB________
Students Name (last) _____________________ (first) _____________Age ____DOB________
Students Name (last) _____________________ (first) _____________Age ____DOB________
Students Name (last) _____________________ (first) _____________Age ____DOB________
Years of Prior Dance
Experience Ballet ___Tap ___Jazz
___Lyrical ___Hip Hop___ Other _____
Please list any medical
conditions that we should be aware of: ___________________________
_____________________________________________________________________________
_____________________________________________________________________________
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PLEASE READ & SIGN THIS
For Office Use Only
Number
of ¾ Hour Classes ___________ Tuition
Amount __________
Number
of 1 Hour Classes ___________ Registration __________
Number
of 1 ½ Hour Classes ___________ Total Due __________
Total
Number of Class Hours ___________ Paid (Cash/Ck) __________
Allegro
Performing
INSURANCE
RELEASE
MINOR CONSENT
I
am aware that during dance lessons, or other related activities, that I am participating
in, under the arrangement of Allegro
Performing Arts Academy, LLC., certain dangers may occur, including but not
limited to, physical injury due to or arising from the dance lessons or other
related activities.
In
consideration of and as part payment for, the right to participate in such
dance lessons or other related activities as provided for by Allegro Performing Arts Academy, LLC.,
and its operators, agents, instructors and other unnamed assistants, I have and
do hereby assume all the above mentioned risks and will hold all the
aforementioned people harmless from any and all liability, actions, causes of
action, debts, claims, demands of every kind and nature whatsoever which may
arise out of, or in connections with, the dance lessons or related activities
provided for by Allegro Performing Arts
Academy, LLC. The terms thereof
shall serve as a release and assumption of risk for my heirs, executors and
administrators and for all members of my family, including any minors
accompanying me. I further state that I
am of lawful age and legally competent to sign this release, that I understand
the terms herein are contractual and not a mere recital, I have signed this
document as my own free act.
This
release will be effective for the entire period I am, or my children are on the
premises of
Parents or legal guardian
MUST sign for all persons under twenty-one (21) years old.
Students Name(s)
____________________________________ Date
________________
Parent’s Signature (or Legal
Guardian) _____________________________________________
I am aware of the following
policies at Allegro such as:
(please
initial)
Tuition due by the 7th
of every month ___________
$20 late fee for tuition
paid after the 7th of each month ________
Tuition will be charged
until we receive confirmation of your withdrawal _________
Expectations of parents and
dancers _______
Absences; missed classes can
be made up by taking other classes. No
refunds. ______
Two yearly showcases;
participation optional _______
Costumes for the June
showcase will be automatically ordered in January for all dancers unless we are
notified by December 7th that you will NOT be participating.
If notification is received
after this date, you will be obligated to pay for the costume. _______