Registration

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Welcome to Beyond Words Dance Center Family Portal! Please provide the requested information below to complete your family account.

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Referral Information
Family Information
Where do you live?
Additional Info
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
(Emails are kept confidential)
Contact #2
How can we contact you?
(Emails are kept confidential)
Student #1
(format=mm/dd/yyyy)
Additional Info
Required Policies and Agreements
As the legal parent or guardian, I am aware that participation in dancing is potentially dangerous and involves risk of injury as with any competitive sport. I understand that these risks include, but are not limited to, injury to ligaments, muscles, tendons, bones, and other aspects of the body that may include head, neck, or spine. Due to the dangers of this activity, I understand the importance of my child (or ward) following the teacher's instructions regarding techniques, training, and other rules and agree that my child/ward will obey these instructions. In consideration for allowing my child/ward to participate in Beyond Words Dance Company, I hereby assume all the risks associated with the sport of dance, and agree to release Kate Jablonski, Inc. d/b/a Beyond Words Dance Company and its employees or agents from any and all liability/responsibility which may arise in connection with my child's (or ward's) participation in activities at Beyond Words Dance Company.

As the legal parent or guardian, I release and hold harmless Kate Jablonski, Inc. (d/b/a Beyond Words Dance Company), Beyond Words Dance Center, its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant while in or upon the premises or any premises under the control and supervision of Kate Jablonski, Inc., Beyond Words Dance Center, its owners and operators or in route to or from any of said premises.

I am aware Kate Jablonski, Inc., d/b/a Beyond Words Dance Company will send me an invoice via email, 10 days prior to the beginning of the upcoming month (PLEASE DOUBLE CHECK THE E-MAIL ADDRESS PROVIDED IN THE CONTACT #1 FIELD ABOVE). The balance is due the 5th of every month. A late fee of $15 will be applied after the 5th of every month. Tuition is based on a 10 month session. You do not need to re-enroll every month. If you choose to withdraw during the year, a written withdrawal must be submitted to the office 30 days before the withdrawal date. A $20 fee will be charged to all returned checks. There are no refunds given for dancers that discontinue taking classes in the middle of a session.

I certify that my child/ward is physically able to participate in Kate Jablonski, Inc. classes and in the event of an emergency, I authorize Kate Jablonski, Inc., d/b/a Beyond Words Dance Company to administer or use their discretion in securing medical treatment. If an emergency occurs, I understand that every effort will be made to contact me/my spouse, the child's guardian, or emergency contact from the information provided on the Emergency Form. I hereby release Kate Jablonski, Inc., Beyond Words Dance Company and its teachers from all liabilities for injuries or damages arising out of personal injury of any kind.

I hereby grant permission for my child/ward to be photographed or videotaped at any dance related events, parades, performances, class activities, etc. Photographs may be published in the studio's newsletter, in local newspapers, or displayed in the studio. Students (including adults) will be videotaped during the recital and/or other dance related activities.

I Agree to All of the Above
Questions or Concerns
Payment Information
Credit Card