Dance Arts Academy Registration Form

(231) 941-4244

www.danceartstraverse.com

To Register by mail, send in the following with check, Visa/Mastercard numbers to address below or Fax to DAA at

231-941-4355 – Class sizes are limited & registration is accepted on a first come basis:

STUDENT’S NAME:________________________________ Date of Birth (if minor):________________

ADDRESS:____________________________________________________________________________

CITY:____________________________________ ZIP:_______________________________________

PHONE: (Home)____________________________ (Work)______________________________________

CELL PHONE: ________________________ E-MAIL: ___________________________________

PARENTS NAMES:_____________________________________________________________________

List all dance training you have had including training (if any) you are currently receiving elsewhere

(where, when, how long, what style, etc.)

______________________________________________________________________________________

List any medical problems or injuries:_______________________________________________________

Please list classes that you wish to enroll in:

Class: Day: Time:

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________________________________ ___________________________ _____________________

________________________________ ___________________________ _____________________

________________________________ ___________________________ _____________________

________________________________ ___________________________ _____________________

________________________________ ___________________________ _____________________

________________________________ ___________________________ _____________________

PLEASE USE PRICE LIST LOCATED ON LAST PAGE OF CLASS SCHEDULE

Tuition Payment is due at time of registration. No Refunds after 1^st week of class – No credits – No transfers.

$10 Non-refundable family registration fee due yearly.

Don’t forget to take your multiple class discounts if applicable. Add $10 Reg. Fee $_______________

“I recognize that dance does involve a risk of harm or injury, therefore, I agree to hold Dance Arts Academy, its teachers and representatives, harmless from any injury I/my child may incur during my/my child’s training here. I have read and agree to abide by the policies and procedures and dress code of Dance Arts Academy.”

Date:______________________

Signature:_____________________________________________(If minor child, parent must sign)

Return completed registration form and check/Visa/Mastercard number to:

Dance Arts Academy, 3811 Marketplace Circle, Traverse City, MI 49684. Or Fax to 231-941-4355

www.danceartstraverse.com