Silhouette Dance Studio Online Registration

Registration

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Welcome to Silhouette Dance Studio 2020 We look forward to sharing the magic of dance with your dancer.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State/Prov*

Postal Code*

Home or Primary Phone*

Additional Info

Emergency Contact Info*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Skill Notes

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Skill Notes

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Skill Notes

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Skill Notes

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=dd/mm/yyyy)

Additional Info

Student Email

T-Shirt Size*

School

Grade Level

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Skill Notes

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Billing & Payment Policies

I am aware that Silhouette Dance Studio requires payment prior to the start of the upcoming term. PLEASE DOUBLE CHECK THE EMAIL ADDRESS PROVIDED IN THE CONTACT #1 FIELD ABOVE. If I wish to re-enrol into the upcoming term, no action is required after my initial enrolment. Priority placement is held. However, I understand that my placement is only held if my account is paid by the due date.

I understand that all public holidays are observed and are accounted for within the fee structure.

Payment preference is through our portal.

First time enrolments will include a one-off, non-refundable $15 registration fee.

Credit cards are not charged automatically when entering card details upon enrolment - please action fee payment through the portal.

I've read the above and agree.

Refund Policy

I am aware that there are no refunds ONCE CLASSES HAVE BEGUN unless due to medical reasons (and with a medical certificate). I understand that Silhouette Dance Studio will not issue refunds for missed classes nor early withdrawal during a term.

I've read the above and agree.

Image, Video & Photo Wavier

I understand that students are filmed for our annual performance dvd, and photographs are taken as a record of concert groups.

Students may also be photographed dancing at workshops or at the studio as a record of an event/ workshop by an authorised staff member. Use of this material is shown only in Silhouette Dance Studio locations such as our gallery in our website, show dvd or Facebook (viewing for 'friends' only). Photos taken are for studio-related audiences only and are for the studio enjoyment - not for promotional purposes. I give permission for my student to be photographed or filmed in these events. If I do not wish for him/her to be photographed or filmed, I will not participate or take part in these events.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State/Prov

Postal Code*