Revolution Elite Dance Summer Dance Intensive Ages 10 and older

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Revolution Elite Dance Summer Dance Intensive Ages 10 and older - Registration Form

PLEASE MAKE SURE YOU HAVE READ THE SUMMER PACKET BEFORE YOU FILL THIS FORM OUT!

Contact Email *

Dancers First and Last Name
*

Contact Phone Number
*

Dancer Date of Birth
*

YYYY

Dancers Age *

Contact Parent Name
*

Contact Phone Number
*

Emergency Contact Name (OTHER THAN PARENT):
*

Emergency Contact - Preferred Phone Number:
*

Emergency Contact - Relationship to Student
*

PLEASE LIST ANY ALLERGIES, PHYSICAL, MENTAL, OR EMOTIONAL PROBLEMS THE STUDENT MAY HAVE:
*

How did you hear about us?
*

Waiver and Release Information: I attest that the above stated physical, mental, and emotional limitations of the student are accurate. I understand that dance and tumbling, sometimes involves extraordinary use of motion. When practicing the art of dance, there are some possibilities for but not limited to the injury of muscle or bones. In consideration for using/ allowing my child/ self, to utilize the facility and staff of Revolution Elite Dance; I hereby forever release the owners, staff, directors, coaches, and all other employees from liability for any injuries suffered by myself or any student in connection with the uses of this facility at 5614 126th Street. I acknowledge that participation is entirely by choice and I am under no compulsion by Revolution Elite Dance to participate in the programs, nor am I being paid to do so. The interest of myself and my child is solely to participate in the art and his/her self-improvement, and I am willing to accept the inherent risk in this pursuit. Untitled Title

Please read statements below and checkbox to indicate you agree to all Waiver and Release Information:
*

I also understand that my child will not participate in class or RED events if all fees are not paid.

Registration fees/ tuition fees are non- refundable or transferable.

I understand that if my child is sent to class not wearing appropriate attire, he/she will be required to sit and watch. He/she WILL NOT be allowed to participate in class.

Revolution Elite Dance also holds the right to dismiss any students from the facility that they feel is not behaving or representing the studio in an acceptable manner.

I grant Revolution Elite Dance & all teachers/staff to post my dancer’s picture on social media.

Required

This acknowledgment of risk and waiver having been read thoroughly and understood completely is signed voluntarily as to its intents and contents. Electronic Signature required. *Type First & Last Name in space provided.
*

Permission to Administer Emergency TreatmentUntitled Title

In my absence, and as a parent or legal guardian of ________________________(student name), I hereby grant my permission, in the event of sickness or injury, to have the necessary treatment administered to my child by a trained professional. In addition, I also grant my permission to have my child transported to the hospital, doctor’s office, or an emergency clinic in the event of such injuries or illness
*

Electronic Signature of Parent/Guardian Required
*

ARE YOU INTERESTED IN AUDITIONING FOR OUR COMPETITIVE TEAM?

Yes

Maybe - Please send me more info

Clear selection

Please indicate the weeks your student will be available for summer classes. SELECT ALL THAT APPLY. Classes are $95 a week. Reminder if you are trying out for Elites you have to have a minimum of 4 weeks!

WEEK 1 JUNE10 & 12

WEEK 2 JUNE 17 & 19

WEEK 3 JUNE 24 & 26

WEEK 4 JULY 8 & 10

WEEK 5 JULY 15 & 17

WEEK 6 JULY 22 & 24

WEEK 7 JULY 29 & 31

Required

Schedule And Pricing:

Level Int./ Adv. Monday and Wednesday 1:00pm – 4:00pm

Level Beg./ Int. Tuesday and Thursday 1:00pm – 4:00pm

Payment INFO: Classes are $95 a week. YOUR FULL PAYMENT AMOUNT WILL BE DETERMINED BY WEEKS SELECTED AT REGISTRATION. 20% off if you sign up AND pay in full for 5 or more weeks. Full payment for the discount is due May 23rd by 7pm. If you choose not to pay in full, payments for June classes are due May 23rd by 7pm and July classes are due June 27th by 4pm Payment must be made on the due date. Your dancer will not be allowed into the classroom if tuition hasn’t been cleared.

Levels: Our classes are broken down by level, not age. We will be able to make placements on the day of registration if you are new. Summer levels are not the same as Fall/ Spring levels so every dancer will be evaluated. TUMBLING LEVELS may change your weekly schedule so please make sure your dancer is present during registration.

Registration and Refunds: Registration for summer must be completed online and then we will contact you to set up payment. $30 registration fee or $50 family registration fee is due at the time of registration to reserve the dancer’s spot as well as a $95 deposit, if you pay in full you will not need to pay the deposit.

Recital 2024 dancers’ registration fees will be $20 and $30 for the family. If payments are not received prior to the due date, your registration will be canceled without any refund.

If you're only available for one day during our weeks we can work with your schedule. This can be discussed when you pay.

ONCE YOU HAVE COMPLETED THIS FORM THE OFFICE WILL CONTACT YOU TO FINALIZE YOUR REGISTRATION. PAYMENT WILL NEED TO BE MADE DURING OFFICE HOURS MONDAY - THURSDAY 4PM - 7PM 806 - 702-8295

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms