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The Dance Centre of Southwest Virginia
Registration Form for 2011-2012
STUDENT LAST NAME FIRST NAME CLASS LEVEL TUITION REG. FEE TOTAL
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___ Levels 5 - 7 Check Box for Jazz Class Registration. Add $20 to tuitiion if checked.
___ Level 4 Check Box for Modern Class Registration. Add $20 to tuition if checked.
Please review the above information carefully and make any necessary corrections. Please sign this form/release and return it to the school with the first month's tuition and registration fees by August 15th to ensure enrollement in class. Your child is not considered registered unless this form is returned. Priority for acceptance in classes will be given based on when forms are received.
Students in Level 4 may register for the 4/5 Modern Class, which will cost an extra $20 per student.
Students in Levels 5, 6, and 7 may register for the Jazz Class, which will cost an extra $20.
Please review this web-site for information on class Dress Codes, the year's schedule, and other important information needed about your class. Please review all this material.
The undersigned do expressly agree to hold harmless The Dance Centre of Southwest Virginia, its agents, its employees, representatives, officers, and directors, against loss from any claims or actions in law brought by the understigned for the purposes of enforcing a claim for damages on account of any injuries sustained in consequence of participation in any Ballet Activity or Class. I also state that the student is in proper physical condition to participate in this program. I have read and will comply with all rules and policies of The Dance Centre of Southwest Virginia.
Signatures:
Parent or Guardian: ___________________________________________________ Date: ______________
Student(s): _________________________________________________________________________________