Sunshine Dance/Bright Lights Theatre Online Registration

Registration

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Thank you for registering your student(s) with Sunshine Dance/Bright Lights Theatre!

* 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
(Not Contact #1 or #2)*

Contact #1

First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work # *

Cell # * Receive Text Message Notifications

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

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender

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

Cell #* Receive Text Message Notifications

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

TShirt Size *

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

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

Cell #* Receive Text Message Notifications

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

TShirt Size *

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

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

Cell #* Receive Text Message Notifications

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

TShirt Size *

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

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

Cell #* Receive Text Message Notifications

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

TShirt Size *

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender

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

Cell #* Receive Text Message Notifications

Additional Info

T-Shirt Size*

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

TShirt Size *

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Release Form

SUNSHINE DANCE/BRIGHT LIGHTS THEATRE
WAIVER AND RELEASE OF ALL CLAIMS FORM

The undersigned, being the parent or guardian of the Student, does hereby consent to the Student's participation in the programs, activities, classes, camps (collectively, "Activities") taking place at Sunshine Dance/Bright Lights Theatre. The undersigned understands and acknowledges that there are certain risks of physical injury inherent in the undersigned's and/or Student's participation in the Activities. The undersigned hereby agrees to and does forever release, waive, acquit, indemnify, and covenant to hold harmless Sunshine Dance/Bright Lights Theatre, its successors, assignee's, officers, owners, volunteers, employees, and agents of any form from: any and all claims, causes of action, liabilities, demands, damages, costs, loss of services, expenses, fees, and compensation as a result of or in any way growing out of, directly or indirectly, any known and unknown personal injuries or property damage which the undersigned or the Student may now have or hereafter acquire, either before or after the Student has reached the age of majority, resulting from or in any way related to the undersigned's and/or Student's participation in the Activities.

BY SIGNING BELOW, THE UNDERSIGNED INDICATES THAT HE OR SHE HAS READ THIS ENTIRE DOCUMENT, UNDERSTANDS IT AND INTENDS, ALONG WITH THE STUDENT, TO BE BOUND BY IT.

I've read the above and agree.

Photography/Video Release

I hereby give Sunshine Dance/Bright Lights Theatre permission to use any photographs or video that may include my child taken during class, recital, events or performances in future marketing materials, on social media and on the Sunshine Dance Website. I understand that there will be no compensation paid for the use of said photos.

I've read the above and agree.

Tuition and Fee Payment Schedule

SUNSHINE DANCE Families: enrollment in the 2019-2020 dance year is a 9 month commitment. I understand that total yearly tuition for all classes in which we enroll will be split into 9 equal payments, paid by your preferred/registered form of payment on the 1st of each month Sept - April. Upon enrollment in a class, tuition for May 2020, in advance, and the annual Administrative Fee of $35 per family will be paid immediately by my preferred/registered form of payment.

Recital fee of $25 per student with additional siblings in the same household paying $5 each (Example: 3 students in one family would pay $35 total) will be paid with your September 1, 2019 tuition. Costume Fee(s) of $75 per student/per class will be paid with your November 1, 2019 tuition.

ALL Families will have their choice of paying through E-check/bank draft which is OUR PREFERRED FORM OF PAYMENT or paying by credit card.

BRIGHT LIGHTS THEATRE CAMPS/CLASSES, SUNSHINE DANCE SUMMER CAMPS/CLASSES AND ADULT DANCE CLASSES will be charged upon enrollment in a class and the above fees do not apply.

SUNSHINE DANCE COMPANY MEMBERS will have a separate Agreement Document.

*All tuition and fees are non-refundable.

Any account with an outstanding tuition balance not paid by the 10th of the month will be charged a late fee in the amount of $25. Late Fees will not be waived. All tuition and fees are non-refundable.

All tuition and fees are non-refundable.

I've read the above and agree.

Tuition and Fee Payment Authorization

I authorize Sunshine Dance/Bright Lights Theatre to withdraw funds from my account and/or charge my credit card for monthly tuition, Class and/or Camp fees and other fees that may include but are not limited to costumes, recital, administrative, competition fees, production, dance wear and shoes. SUMMER REGISTRATIONS, BRIGHT LIGHTS THEATRE CLASSES/CAMPS/ADULT CLASSES will have a one time charge upon enrollment with no other fees. * All tuition and fees are non-refundable

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 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