Registration

Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact Info*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
POLICIES - I have read, understand, and will comply with all of the policies of the Dance Factory and the requirements for the 2019 Mini Company.*
REQUIREMENTS - As listed in the Mini Company Details my child plans to participate in the required CORE classes, rehearsals, competitions, etc.*
BIRTH CERTIFICATE - I will submit a copy of my child's birth certificate. PERTAINS TO NEW COMPETITION STUDENTS ONLY.*
FEES - I understand that all fees are non refundable, will be automatically debited when due unless prior payment is received, and that I must have an active credit card on file at all times.*
Please enter the total number of competition dances you are willing to participate in / pay for. Please take into consideration: costume fees, rehearsal fees, entry fees.*
I would like my dancer to participate in MINI CONTEMPORARY class. I understand the additional tuition fees. This class is not a competition dance, but will perform in the May concert.*
I would like my dancer to participate in MINI HIP HOP class. I understand the additional tuition fees, costume fees, and entry fees.*
I would like my dancer to participate in MINI TAP class. I understand the additional tuition fees, costume fees, and entry fees.*
I would like my dancer to participate in MINI ACRO FOR DANCE class. I understand the additional tuition fees. This class is not a competition dance, and will not perform in the May concert.*
I would like my dancer to participate in a MINI SMALL GROUP dance. I understand the additional rehearsal time, rehearsal fees, costume fees, and entry fees involved.*
Please list any other activities you are involved in and any conflict dates.*
*I UNDERSTAND THAT IN ORDER TO AUDITION FOR THE 2018 COMPANY MY ACCOUNT MUST BE CURRENT. NO EXCEPTIONS.**
On May 8th, my credit card will be charged $65 for the following; $20 audition fee and $45 registration fee*
By checking the "yes" box, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement.*
*I have read through and answered all of the above questions. INCOMPLETE FORMS WILL NOT BE ACCEPTED.**
 
Additional Information:
 
 
Other Questions/Comments:
 
Credit Card Verification:
   
Card Number: *  
Name as it appears on card: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*