TU LEFT FEET SPRING 2021 REGISTRATION FORM
-1 Student Per Registration Form.
-Tuition is due by the 1st of the month through June 2021.
-All tuition is to be paid monthly.
-In the event of a mandated shut down/stay at home order your class will be taught via Google Classroom for the remainder of the current month and subsequent months will be offered at a discount if we need to move them online.
-All students must keep a card on file and that card will be charged on the 1st of the month, or the next business day, if tuition has not been paid via cash or check in house.
-Costumes are an additional fee and will be ordered once a date for a performance can be confirmed.  All costumes and participation in performances are optional, you will not be billed a costume invoice if you do not wish to participate in the performance.  All costumes are made to order and are non-refundable.
-A place will not be held for your student unless the registration form and registration fee ($50) have been received via our website.  Class sizes are extremely limited and are filled on a first come, first serve basis.
-$50 Registration Fee for all new students will be drafted from the card you provide on this form.

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Email *
Please select the 1st class you would like to register for: *
Please select the 2nd class you would like to register for:
Please select the 3rd class you would like to register for:
Student's 1st Name *
Student's Last Name *
Student's Date of Birth *
Student's Age *
Student's Current Grade Level *
E-Mail Address *
important updates, information, newsletters and closings will be sent to this address
Parent or Guardian Cell Phone *
(Emergency Contact)
Parent or Guardian's Name *
(Emergency Contact)
Alternate Phone *
what number do we contact if we can not reach the emergency contact listed above?
Secondary Parent or Guardian's Name *
who do we contact if we can not reach the emergency contact listed above?
Previous Experience *
please select any and all that apply
Required
Length / Location / Level of Previous Experience
this will help us determine the appropriate level and class for your child
Allergies, Previous Injuries, Illnesses, etc.
Release of Claims and Treatment Authorization
I am aware that dance, yoga, gymnastic and any physical exercise associated with it, place unusual stress on the body and carry with them the risk of physical injury.  On behalf of my child and/or myself, I assume this risk and agree that  Tu Left Feet, LLC and its staff shall not be liable in anyway for the injuries sustained during attendance at the studio, located at 13214 Midlothian Turnpike, Midlothian, VA 23139 or any of its away functions.  I grant my child/myself permission to participate in the 2021 season; and  I release and discharge any claims, demands, actions, judgments, and executions to which the students, heirs, executors, administrators or assigns may have, or may claim to have against Tu Left Feet, LLC, its successors, its assigns for all personal injuries caused by, or from the above activities or any activities related.  Further, I grant, Tu Left Feet, LLC and its employees permission to authorize any emergency medical treatment that may be required during the 2021 season.
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Photography Release *
I, the parent/guardian (or student, if 18+) authorize Tu Left Feet, LLC and/or its representatives, agents, or staff to use any photographs of my child (or myself), for any purpose, including publicity, choreographic archives, promotional materials and/or any other reason deemed appropriate by the artistic staff or marketing director.
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