Mebane's Leading Dance Facility & Home of Elite Feet Cloggers
Online Fall Registration Form 2011-2012 Student Name: _________________________________ Age: ________ DOB: _______________ Gender: F / M (Circle One) Parent/Guardian: __________________________________________ Address: ______________________________________________________________________C/S/Z Phone: If this Changes at anytime please notify us immediately. (H)________________________(W)_________________________(C)__________________________ Email: _______________________________________________ Class/es Requested – Please circle Ballet Tap Jazz Lyrical Clogging Hip Hop Acro Adult Ballet/Tap-Combo(3-5yrs) Ballet/Tap/Jazz-Combo(5-7yrs) Cheer Technique Pointe Competitive Team Does this student have any medical conditions that XDA should be made aware of? Y N If yes please specify: _______________________________________________________________________ XDA does not carry medical insurance for its students. Each student is required to be covered by their own family medical policies, and if any injury occurs it is understood that the student’s own policy is their only source of reimbursement. A registration fee is required of all new and returning students. Class space is not held until registration fee is paid. $30.00 For all Students. Late Fee on Tuition paid past 30th of each month is $15.00 Studio Policies: * Any Dancer causing difficulties in class may be asked to leave at the studio directors discretion. * No dancer will be allowed into class without proper dance wear, shoes, hair and no jewelry. This enforced to ensure your dancers safety. * No food, candy, or drinks other than water will be allowed in the dance area and dancers must clean up their food mess in the lobbies beforethey leave. * Permanent Dismissal: Disrespecting the teacher, teasing other classmates, not attending class regularly (if you miss more than 4 in a row). Do Not stand outside the studio and hang out with boys! This is not becoming of a young lady nor does it set a good example for the younger students. * All photos taken by Xtreme Dance Academy are property of Xtreme Dance Academy and may be used for any ads, flyers, etc. Yearly Expences:
* No Refund policy if you drop your class mid month. Payment still due for month dropped. ______ * Registration Fee (Not Refundable—this hold your class space) $30.00 for all students ______ * Parade Sweatshirt : $18.00-$20.00. All dancers and tumblers must attend the Mebane Parade Only! Other Parade attire that is needed; Black Turtleneck, Black Jazz Pants and Clean tennis shoes, Black Gloves and Black Toboggan. ______ * Costume Deposit: $50.00 for Dancers and $30.00 for Tumblers Due Before October 1st. Final Costume Payments Due by Dec 10th and there is a $10.00 late fee charge per costume for any that are ordered after the 10th. You may pay in extra as you go! Not Refundable After Nov 1st _______ * Cap Sleeve T-shirt: These will be ordered in March and cost between $14.00-$18.00 and all dancers and tumblers performing in the Dogwood Festival and Recital are required to have one. ______ *Recital Fee due April 1st –15th and is not refundable. This may vary with each dance season. Cost based on venue and is $60.00 for 1 dancer and $30 for each additional student that you have. Any drop after January 1st of Dance Season is still required to pay this fee. _____ Parent Signature: ________________________________________________ Date:_____________ In signing this you state that you have read the above information and agree to all terms and policies
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