Soul2Sole Dance, Inc. Online Registration

Registration

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Thank you for choosing Soul 2 Sole Dance, Inc. as your studio! Your business is greatly appreciated! All families must fill in the information below and agree to the waiver.

* 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*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info*

Current, New or Old Student?*

Cash, Check, Credit Card?*

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

Who is your employer?

Employer

Employer Phone

Employer Notes

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

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Please select your classes below. You can filter by type of dance class, day, and/or teacher. You can also type in your child's age to see only those classes that are for that age. Please sign up for the classes that correspond with your child(ren)'s age and level.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Student Email

Disabilities (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Primary Doctor

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Waiver & Release of All Claims

I, as the legal parent or guardian of the child(ren) listed on the Soul 2 Sole Dance, Inc. 2019-20 registration form, have chosen to have my child(ren) participate in dance instruction and/or programs at Soul 2 Sole Dance, Inc. I acknowledge that I understand the nature of the activities my child(ren) will be participating in and that my child(ren) is/are in the proper physical condition and capable of participating in the related activities, understanding that Soul 2 Sole Dance, Inc. is not in any way responsible for making such a determination. I also give permission to Soul 2 Sole Dance, Inc. to seek medical treatment for my child(ren) in the event they are not able to reach a parent or guardian.
In consideration of my child(ren)'s enrollment in any dance instruction or program, I understand and agree on behalf of myself and my child(ren), to release, hold harmless, and discharge Soul 2 Sole Dance, Inc., its owners, officers, staff, employees and independent contractors from all claims, costs, liabilities, expenses or judgments, including attorneys' fees and court costs for any occurrences in connection with any dance instruction or programs at Soul 2 Sole Dance, Inc. I assume all risks to my child(ren) in connection with any instruction or participation in programs and further release Soul 2 Sole Dance, Inc., its owners, officers, staff, employees, or independent contractors from any li-ability for any injury sustained by my child(ren) while he or she is enrolled in any dance instruction or program, including all risks reasonably connected with such activity whether caused by negligence or any other cause foreseen or unforeseen.
I understand that Soul 2 Sole Dance, Inc. is not responsible for my child(ren) or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio.
I understand that Soul 2 Sole Dance, Inc. is not responsible for personal property that is lost, damaged or stolen while I or my child[ren] is on Soul 2 Sole Dance, Inc. property.
I authorize and agree that Soul 2 Sole Dance, Inc. may take and use photographs, videos or likenesses or my child(ren) as needed for its record-keeping, advertising, social media, and/or public relations projects and that I have no rights to the same and will not be compensated for the same.
My signature is proof of my intention to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and agreement as to all terms and conditions contained above. I am of lawful age and competent to sign this affirmation.
I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS WAIVER AND RELEASE AND HAVE READ THE SAME PRIOR TO SIGNING.
I understand that my child(ren) will not be enrolled in any class[es] or programs at Soul 2 Sole Dance, Inc. without this signed Waiver and Release of All Claims form.

I've read the above and agree.

Payment Information

Please see below for breakdown of SCHOOL YEAR FEES (2019-2020).

- Class fees are PER CHILD and cannot be combined with siblings.

- Families can either pay by credit card, check or cash. Please specify under "Billing Info."

- For the Winter Session, if you would like to pay by check or cash, payment must be brought in by Friday, November 1. If payment is not brought in by November 1, the credit card you have on file will be charged.

- If you are signing up for more than one class as a 1st or 2nd choice, please note this in detail in the comments section below.

- There is a $30 Admin Fee per family when signing up. This fee is once per school year and is not refundable.

- For any classes that are dropped less than two weeks prior to the start of a session, funds will not be returned to the original payment method. Instead, an account credit will be applied.

- Pricing is per session. There are three (3) sessions per year.

I've read the above and agree.

Pricing

45 minute class: $190
90 minute class: $420

1 60 minute class: $280.00
2 60 minute classes: $515.20
3 60 minute classes: $730.80
4 60 minute classes: $940.80
Additional 60 minute classes over 4: $195 each

Art Enrichment: 1 hr: $280, 45 min: $215
Lunch Bunch: 30 min: $50
Snack: $25

* Company Pricing is not shown here. Please refer to separate company email.

Parent(s) and/or caregiver must agree to follow all studio policies and understand that registration will not be accepted without parent signature on registration form and studio waiver. For a full list of Soul 2 Sole Dance, Inc. policies, please visit the website at www.soul2soledance.com.

I've read the above and agree.

Photo/Video Waiver & Release

Soul 2 Sole Dance, Inc. will take photos and video footage of classes, special events, and camps. By signing the registration form, you are giving Soul 2 Sole Dance, Inc. permission to use these photos and video footage in brochures, advertisements, social media, and on the studio website.

Soul 2 Sole Dance, Inc. is a NUT-FREE ZONE. Please refrain from bringing any nut products into the studio. Upon registration, Soul 2 Sole Dance, Inc. must be notified about any medical conditions that might require special attention by the studio staff. All information will remain confidential.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

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