Dance Fusion Online Registration

Registration

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Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info

Contact #1

Contact 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

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Allergies (Leave blank if NONE)

Prior dance experience

Enroll in Classes

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Allergies (Leave blank if NONE)

Prior dance experience

Enroll in Classes

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Allergies (Leave blank if NONE)

Prior dance experience

Enroll in Classes

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Allergies (Leave blank if NONE)

Prior dance experience

Enroll in Classes

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Allergies (Leave blank if NONE)

Prior dance experience

Enroll in Classes

Add Another Student

Required Policies and Agreements

Payment Policies

Tuition is based on the entire dance year program which is spit into even monthly payments. It is calculated based on the number of hours a student takes class each week. All vacations and holidays have been taken into account. Payment is due on the 1st of each month and will automatically deduct from the credit card, debit card, or bank draft on file. In the event that a card is declined or invalid a $10 late fee will be applied after the 5th of that month. There is a $25.00 fee on all returned checks. Payment in cash will be accepted but must be made before the 1st of the upcoming month. NO credits, refunds, or adjustments will be given for absences or classes cancelled due to the weather; however, if more than one class is cancelled due to the weather, a make-up class will be offered.

I've read the above and agree.

Tuition Discounts

A 5% discount will be given to immediate family members with two students registered- first student (highest tuition) will pay full price, while the second student will receive the 5% discount off their tuition only. A 5% discount will be given to immediate family members with three or more students registered- first student, full price; second student, 5% off; third (and any additional) student will receive 5% off their tuition only. If tuition is paid for the whole year a 10% discount will apply. (Family discount and whole year payment option discount can not be combined.)

I've read the above and agree.

Registration

Registration is $25 per student/$50 per family and must be paid at time of registration to hold spot in class.

I've read the above and agree.

Costume Policies

Costumes range from $70-$85 per costume. All costumes must be paid by February 1st and will automatically deduct from the credit card or bank draft on file. Costume amounts will be posted to accounts by January 2nd and will include any credits from fundraising. Payment by cash will be accepted anytime before February 1st. There are no refunds once a costume order has been placed. Please note that costumes are not custom made and will be purchased with room to grow depending on the costume company's size chart. Any alterations are the responsibility of the parent.

Please note that competitive class costumes may be a higher price and may need to be ordered earlier.

I've read the above and agree.

Recital Video

A mandatory fee of $20 per family is due on June 1st and will automatically deduct with normal tuition. This fee includes your access to professional videoing of both recitals for each family by DRC Video Productions.

I've read the above and agree.

Photo & Video Waiver

I understand that my child's likeness may be used in Dance Fusion ads, promotional videos, website material, or other various marketing. These images will be used for Dance Fusion purposes only, and will not be given or sold to outside companies or individuals.

I've read the above and agree.

Assumption of Risk

Participation in physical activities can involve motion, rotation, and height in a unique environment and as such carries with it a certain assumption of risk. The undersigned and the participant(s) choose to voluntarily enter 315 Main Road, Tiverton RI, under the control of Dance Fusion, knowing their present condition and knowing that said condition may become more hazardous and dangerous during the time the participant or the undersigned is upon said premises. The undersigned and the participant(s) voluntarily assume any and all risks of loss, damage, or injury that may be sustained by the participant(s) and/or the undersigned or any property owner by them while on or upon said premises described above. Dance Fusion may but shall not be obliged to carry insurance on the participant(s), and the existence of insurance shall not change, alter, or increase the liability of Dance Fusion to the participant and the undersigned or affect the terms of this Release. In signing this Release, the undersigned acknowledges: a) That he/she has read thoroughly and understands completely, the terms of Registration and Release and signs it voluntarily.
b) That the undersigned signing either for themselves, or as Legal Guardian is, in fact, the true and legal guardian and has the consent of the participant.

I've read the above and agree.

Medical Emergency

The undersigned gives permission for Dance Fusion owners, employees, and/or agents to seek emergency medical treatment for the participant(s) in the event they are unable to reach any parent or guardian. The undersigned also agrees that they themselves will be responsible for any financial debt incurred by said action.

I've read the above and agree.

Cancellation Policy

All cancellations must be in writing before the 1st of the upcoming month. There will be no refunds after this time.

CANCELLATION NOTICE MUST BE IN WRITING in the form of...
(1) e-mail to dancefusionri@hotmail.com (you will receive e-mail confirmation)
(2) Certified mail to 315 Main Rd. Tiverton, RI 02878.
(3) Completed cancellation form available at the studio.
CANCELLATION BY PHONE WILL NOT BE ACCEPTED.

I've read the above and agree.

I Agree to All of the Above

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Questions or Concerns

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Payment Information

Please fill out ONE of the following Payment Methods

Credit Card

Card Number

Exp Month

Exp Year

Card Nickname

Name as it appears on card

Address Line 1

Address Line 2

City

State

Zip

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number