SPRING 2023 ENROLLMENT FORM
-1 Student per enrollment form.

-Classes are held once a week January 9 - June 10.  
*Except Ballet Technique ( Pre-Pointe + Pointe ) classes are held on Tuesdays + Thursdays.*

-Tuition is due January - June.

-A place will not be held for your student unless the enrollment form and $50 registration fee have been received.  Class sizes are extremely limited and are filled on a first come, first serve basis.  The registration fee is non-refundable.  

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Email *
Secondary E-Mail Address *
important updates, information, newsletters and closings will be sent to this address
Please select the classes you would like to register for: *
Required
Student's 1st Name *
Student's Last Name *
Student's Date of Birth *
Student's Age *
Student's Current Grade Level *
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, acrobatic arts, gymnastics 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 13110 Midlothian Turnpike, Midlothian, VA 23113 or any of its away functions.  I grant my child/myself permission to participate in the 2022-2023 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 participation. 
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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