Phoenix Rising Dance Studios Online Registration

Registration

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Welcome to Phoenix Rising Dance Studios 2! Please complete the following registration form.

* 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*

Contact #1

Contact #1 First Name*

Last Name *

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

Special Needs

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

Special Needs

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

Special Needs

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

Special Needs

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

Special Needs

Allergies

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

Enroll in Classes

Add Another Student

Required Policies and Agreements

Dance Studio Location

I understand that Phoenix Rising Dance Studios is moving to 5122 E 65th Street, Indianapolis, IN 46220. I understand the studio is set to open on April 8, but that date could be delayed due to construction or other issues.

I've read the above and agree.

Health and Medical Release Waiver

I acknowledge that participation in dance is potentially dangerous and that there is an inherent risk of injury involved. In allowing my child to participate in Phoenix Rising Dance Studios activities, I hereby assume all the risks associated with the performing arts. I understand the importance of myself and my child following the instructions and rules set by their instructor(s), and I agree to release Phoenix Rising Dance Studios and it's owners, directors, and employees of any and all liability which may arise as a result of my child's participation in activities at Phoenix Rising Dance Studios.

I've read the above and agree.

Photo and Video Release

I give permission for Phoenix Rising Dance Studios to use video footage and/or photographs of my child. This usage may include (but is not exclusive to) displaying publicly, distributing, or publishing, photographs and/or videos of my child for use in materials that include, but may not be limited to: 1) Printed materials such as brochures and newsletters, 2) Online and offline advertising and promotion, 3) Videos and digital images such for use on social media. By registering through this site, I acknowledge that I am giving unrestricted permission for my child's image to be used in print, video, and digital media. I agree that these images may be used by Phoenix Rising Dance Studios for a variety of purposes and that these images may be used without further notification. I do understand that any identifying information including last names and locations will not be used in conjunction with any video or digital images.

I've read the above and agree.

Auto-Pay Acknowlegement

Phoenix Rising Dance Studios requires the family have a debit/credit card or a bank account on file. Tuition fees are posted on the 28th of every month, and charged on the 1st, unless the 1st falls on a Sunday, in which case they will be charged the first business day of the month. This requirement reduces accounting hours and late fees, and allows Phoenix Rising to keep tuition and other fees as low as possible.

I've read the above and agree.

Safe Space Acknowlegement

Phoenix Rising Dance Studio is a "Safe Place" for all it's students. All students should feel like they're in a safe environment when they are training here. Any type of bullying, name calling, shaming, or unwanted physical contact between students is strictly forbidden. All students should be encouraged to find a studio director and report any behavior that makes them feel uncomfortable in any way. Phoenix Rising is committed to addressing these situations on a case-by-case basis. Students who have trouble adhering to the Safe Place policy will be reminded of this policy. If behaviors don't improve, a meeting will be held with a studio director, the student, and the student's parent or guardian. Any student failing to observe behavior policies after that will be asked to leave the studio

I've read the above and agree.

No Conflict Policy

Phoenix Rising maintains an open-door policy to all parents and guardians of students enrolled at the studio. If a parent or guardian has any issue, we ask that they schedule a meeting with the studio director. In that meeting, the parent or guardian can PRIVATELY discuss the issue and seek out a conclusion. Parents sharing negative issues with other parents, staff, or instructors tends to do nothing more than stir up tension, making it harder for the studio to run smoothly. Every minute the Directors spend getting to the bottom of conflict and drama is a minute we're unable to focus on what's really important here, your children and their dance education. Parents who can't adhere to the no conflict policy, or make public shows of dissatisfaction in the studio will be asked to leave.

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