Registration forms

Please fill out the registration forms completely, including age and date of birth, as well as the Release form - Thanks

Children will be placed according to their ability so that the child may prosper and grow. This placement will be under the discretion of the Teacher and Director.

Click here for Downloadable Registration form

 

DANCE CLASS REGISTRATION 2010 / 2011

Registration will not be accepted without full payment.  Please print the form and mail to the studio.

 

STUDENT                                                                  STUDENT

LAST NAME: ________________________            FIRST NAME: ____________________________

 

AGE: ________________                                          DATE OF BIRTH: _________________________

DESCRIPTION ( ex. - pre-dance 3-4, tap/jazz 7/8)	DAY	TIME	MONITOR(YorN)
1
2
3
4
5
6
7

Monitors: A Monitor is an adult that can stay during class as a silent observer.   If you are available to monitor classes, please indicate above.  You will be notified if you are needed.

 

PARENT/GUARDIAN NAME: _______________________________________________

 

HOME ADDRESS: _________________________________________________________

 

CITY: _____________________________________ STATE: ________________ ZIP: ________________

 

HOME PHONE: ___________________________ WORK PHONE: _____________________________

 

CELL PHONE: _____________________  

 

 

 

E-MAIL ADDRESS:

Please print in box above

 

·         Registration is based on first-come, first-served basis.  Be sure to fill this form out completely.

·         Please be sure to fill out the Student Release Permission Form as well.

·         Tuition must be paid in FULL for all classes. Tuition not paid in full will not be accepted. Please feel free to make copies of this form for each child registering.

·         Please indicate the students’ name on your check.

·         Your choice of class/classes will be first priority. If Classes are full you will be notified of an alternate class.

·         Children will be placed according to their ability. This placement will be under the discretion of the Teacher and Director.

 

Please make checks payable to:     St. Saviour’s School of Dance

Mailing address:                             350 Sound Beach Avenue    Old Greenwich, CT 06870

           

The Student/Parent acknowledges that in using the facilities, programs and equipment of St. Saviour’s School of Dance he/she does so entirely at his/her own risk.  Student/Parent expressly agrees that St. Saviour’s School of Dance and its staff shall not be held liable for any personal injuries or any loss or damage to personal property sustained by student/parent on or about the premises of St. Saviour’s Church/School of Dance.  Student/Parent gives permission for any photographs or video to be used for advertising for St. Saviour’s School of Dance.  If student is not returning second session a written letter to the director is due by December 1^st or Student will be responsible for full costume fee of $75.00(seventy-five) per class.

 

                                                                                                                                                                       

Signature of Parent    (if student is under 18)                            Signature of Student (if 18 or older)

 

  STUDENT RELEASE PERMISSION FORM à

 

 

St. Saviour’s School of Dance

Student Release Permission Form

 

Name of Student:        _________________________          Age: ______

(Last Name, First Name)

 

Parents/Guardians of Students (Ages 3 to 8)

 

Students ages 8 and under are NOT allowed to wait outside in the parking lot.  An adult must enter the dance studio to pick up the student.

 

Who is authorized to pick up the student after dance class?

 

Name:  _______________________________________     Relationship: _______________

 

Address:          __________________________________   Telephone:    _______________

 

Name:  _______________________________________     Relationship: _______________

 

Address:          __________________________________   Telephone:    _______________

 

 

Parents/Guardians of Students (Ages 9 to TEENS) ONLY

 

Although discouraged- ONLY students ages 9 and older are allowed to wait outside when or if parental permission is obtained. Check appropriate line below to grant permission.

 

Does your child have permission to wait outside in the parking lot area to be picked up after dance class?

 

Yes:     ______________                                            No:      _____________

 

***Although you may give permission for your child to wait outside, it is encouraged that you come into the studio at least once a month  to make sure appropriate notices are getting home and the instructors can meet you. Thank you for your consideration.

 

I give permission to St. Saviour’s School of Dance to take whatever emergency measures are judged necessary for the care and protection of my child while she/he is under the supervision of the Dance School. I understand that, in some situations, Dance School Staff may need to contact local emergency resources before the parent or guardian may be reached.

 

 

________________________________           _____________________________      _____________

     Signature of Parent/Guardian                              Name of Parent/Guardian (please print)            Date