In Motion Dance Studio Online Registration

Registration

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Welcome to In Motion's On-line Registration! Please complete the following form to register for a dance class. Please note there is a $15/student or $25/family registration fee. We will process your payment using the credit card or bank account you provide in this registration.

* 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*

Click to Enter an International Number

Contact #1

Contact #1 First Name*

Last Name *

How Can We Contact You?

Home Phone

Click to Enter an International Number

Work #

Click to Enter an International Number

Cell #

Click to Enter an International Number

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

How can we contact you?

Home Phone

Click to Enter an International Number

Work #

Click to Enter an International Number

Cell #

Click to Enter an International Number

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

School

Grade*

Allergies

Please click on the Search button below, then choose the class.

Enroll in Classes

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

School

Grade*

Allergies

Please click on the Search button below, then choose the class.

Enroll in Classes

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

School

Grade*

Allergies

Please click on the Search button below, then choose the class.

Enroll in Classes

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

School

Grade*

Allergies

Please click on the Search button below, then choose the class.

Enroll in Classes

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

(format=mm/dd/yyyy)

Additional Info

School

Grade*

Allergies

Please click on the Search button below, then choose the class.

Enroll in Classes

Add Another Student

Required Policies and Agreements

Liability Release

I realize that dance and dance related activities involves some risks. In consideration of my/my child's participation in these activities, I release and discharge In Motion Dance Studio, Inc. and instructor's from any and all liability arising from accident, injury, and illnesses that my child/myself may suffer as a result of participation in this activity.

I've read the above and agree.

Photo/Video Release

I hereby give permission for images of my child, captured during regular classes, rehearsals, performances and special activities through video, photo, and digital camera, to be used solely for the purposes of In Motion Dance Studio promotional materials, website, and publications, and waive any rights of compensation or ownership thereto.

I've read the above and agree.

Tuition Payment Policy

I understand that my monthly tuition, will automatically be withdrawn on the 7th of each month from either a Credit Card, Debit Card, or bank account that I provide.
Cash, Checks, or money orders will be accepted if paid by the 5th of each month. Otherwise, tuition will be automatically charged to a credit card, debit card, or withdrawn from a bank account by the 7th.
I understand that I will need to complete an Auto Withdraw Form, which must be completed and returned to the studio office no later than Sept 5. (If a returning student, In Motion will have last year's Auto Withdraw on file to use).
I understand that if my child decides to discontinue her dance lessons, I must call the studio office immediately to stop future tuition charges from being added to my account. I understand, before I leave, I will be responsible for any balances on my account.

I've read the above and agree.

Recital & Dress Rehearsal

I understand that this year's Recital is held June 1-3, of 2018, and my child is expected to attend, unless I notify In Motion by October 15, 2017, stating otherwise.
I understand there is a mandatory dress rehearsal held May 30 (recital 1) & May 31 (Recital 2).
Class rehearsals are held the following dates at the Ritz: May 19, May 21-25, and May 29, and my child's class will have a rehearsal on one of these days. (Schedule released in March).

I've read the above and agree.

Recital Costume Policy

For the Recital, I understand that my child will need a recital costume and tights. The total cost of my child's tights and costume are divided up into 3 deposits. Deposit #1 is due October 7 ($27/costume), deposit #2 is due November 7 ($27/costume), and my final costume deposit ($27 or less/costume)....due December 7. I understand that there are no refunds for costumes once ordered. These deposits will be taken out automatically on the 7th or I may pay cash/check by the 5th.

I've read the above and agree.

Other Studio Policies

I understand that my child is expected to attend class regularly and on time. If my child arrives more than 15 minutes late to class, she/her will be asked to observe instead for his/her safety.
I understand that my child needs to follow the studio dress code and must wear her hair up for class. It is my responsibility to have her hair up before she enters the classroom.
I understand that I will need to read any and all studio notes, emails, and other handouts in a timely manner to stay current on important information, changes, or deadlines at the studio.

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