The Movement Xperience of Lake Houston Online Registration

Registration

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Welcome to The Movement Xperience! 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*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)*

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

Contact #2

Contact #2 First Name*

Last Name*

How can we contact you?

Home Phone

Work #

Cell # *

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

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

Cell #

Additional Info

Student Email

School*

Grade Level*

Allergies (Leave blank if NONE)

Costume Size:*

T-Shirt Size:*

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)

Cell #

Additional Info

Student Email

School*

Grade Level*

Allergies (Leave blank if NONE)

Costume Size:*

T-Shirt Size:*

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)

Cell #

Additional Info

Student Email

School*

Grade Level*

Allergies (Leave blank if NONE)

Costume Size:*

T-Shirt Size:*

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)

Cell #

Additional Info

Student Email

School*

Grade Level*

Allergies (Leave blank if NONE)

Costume Size:*

T-Shirt Size:*

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)

Cell #

Additional Info

Student Email

School*

Grade Level*

Allergies (Leave blank if NONE)

Costume Size:*

T-Shirt Size:*

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

Enroll in Classes

Add Another Student

Required Policies and Agreements

Forms

All families must fill out an Application and Authorization form. These are available at the studio and online at our website www.tmxdance.com. Please go to Schedule and download the Registration Forms document. These forms MUST be turned in before the first class for new and returning students. Thank you!

I've read the above and agree.

Tuition and Payment Policies

There is a $40 non-refundable registration fee for the first student in each family, $35 for the second student, $20 for the third. Max $95 per family.

At the time of registration, a nonrefundable double installment is due. Tuition installments are then due on the first of each month beginning October and ending May. If you choose to not do a double payment, Payments will begin August and September. Payments made after the 1st of the month will incur a late fee of $15. Any payments not made by October 1, will be automatically drafted. A $50 fee will be applied to all returned checks. Students will be dropped from a class or recital costumes withheld for accounts unpaid more than 15 days after due date.

Cash and/or checks are preferred; however, bank draft or credit card is also accepted. Bank Draft is required on your file and can be used for auto-draft payments. A credit card must also be on file as a back-up. If your bank draft is rejected, your credit card on file will be used. If both of these are rejected, payment must be made in cash at the studio with a $50 return fee. All payments are non-refundable and non-transferable. Your last payment will be due May 1st.

Tuition does not vary and is not prorated in the event of absences, holidays, days in the month, etc. The Movement Xperience follows the school calendar for closures. If a day is missed in a week due to a holiday or weather closing, you may make the class up during that week. For instance, due to New Years, Monday students may pick a make-up class during that week back.

I've read the above and agree.

Classes

The Movement Xperience reserves the right to cancel a class or change the time/day due to an enrollment of less than 5 students.

The Movement Xperience observes the school calendar for holidays and school closures due to weather.

Dropping a class must be done in writing and received in the office by the last day of the month & will be effective the last day of the following month. Example: Turn in drop notice by October 31, the effective drop date is November 30. Registration and tuition fees are non-refundable and non-transferable. Tuition will not be refunded if dropping classes at the start of the month.

Make-up classes are always encouraged. If making up a class, please find one that is most similar to one in which you are enrolled. Please ask your teacher if you are not sure which make-up class is best. You will not be credited for any missed classes.

I've read the above and agree.

Medical Responsibility

You give permission to The Movement Xperience owners, faculty, staff, and associates to seek emergency medical treatment for the participant(s) in the event they are unable to reach any parent or guardian, and that you will be responsible for any finances incurred by this medical attention. Please note that no child may administer medicine to themselves without the presence of a parent at the studio. If your child needs medication while at the studio, for any reason, you agree to notify the front office.

I've read the above and agree.

Release of Liability

You as the legal parent or guardian release and hold harmless The Movement Xperience owners, staff, faculty and associates from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury that may be sustained by the participant and/or the undersigned during membership and/or association with The Movement Xperience, including classes, master classes, special events, and transportation to/from such occasions. You also understand that The Movement Xperience is not responsible for any theft, loss, or damage of personal items.

I've read the above and agree.

Advertising & Promotion

You hereby grant The Movement Xperience &The Movement Xperience affiliates the irrevocable and unrestricted right to use, reproduce and publish photographs and videos of your child for editorial, trade advertising, or any other purpose or manner and medium. You also hereby release The Movement Xperience , The Movement Xperience affiliates, owners and staff from any and all claims, actions and liability relating to its use of said photographs and videos.

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 BOTH 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 *