Encore Dance Studio LLC
	  ^Last ^Initial	         Registration and Release Form	^Date:   	

Student: First Name	Last Name	Date of Birth	Age	Female/ Male

Home Address	City /	Zip
Parent/ Guardian (Mother):   	
Student’s Email: 	

Email Address:	Student’s Cell: 	

Home Phone Number	Work Phone Number	Cell Phone Number

Parent/ Guardian (Father):   	

Email Address:   	

Home Phone Number	Work Phone Number	Cell Phone Number

Responsible person other than above.	            Relationship	      Phone(s)
Doctor:	Phone: |
In an emergency situation, a medical technician may need to know the following information regarding my child’s health: allergies, chronic illnesses, seizures, etc.  Use the space below. (Write “None” if none.)

I/We, the parent/guardian of the above named student, a minor, and the above named student agree to the following:

  	__	1. STUDIO POLICIES: I have read the Statement of Understanding and the Studio Rules and agree to abide by them.

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2.	PHOTO/IMAGE RELEASE: I give my consent for images (photographs, video) of my dependent to be taken and used to
document the activities of Encore Dance Studio LLC. I grant permission to use the images for educational and promotional purposes. I understand that if I do not want images of my dependent to be used, I will indicate this in writing and the signed letter will be   attached to this document. Encore Dance Studio is not responsible for any outside posting through social media.  
      Student and Parent Use of Cameras & Video cameras
Filming and photography in class is only allowed when permission is granted by the teacher/choreographer. Due to strict Privacy and Copyright laws, recorded footage MUST NOT be shared in public or on any social media without the consent of the studio, teacher/choreographer, and subjects. We understand that one of the best ways to practice routines is to record and watch/rehearse the steps repeatedly. Because of this, we do allow students and occasionally invite parents into class to record routines intended for rehearsal purposes only. Please do not film through windows and make sure permission has been granted before recording. Any abuse of this agreement will result in the student/parent being asked to delete all footage.

3.	MEDICAL RELEASE: I give my permission for Encore Dance Studio Teacher, or Studio Parent to take my child to a medical/dental facility, if necessary. In case of emergency, if none of the above can be contacted, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. I accept full responsibility for all costs of said medical care and any emergency treatments. Encore Dance Studio LLC will not be responsible for the cost of any medical care or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments.

4.	WAIVER AND RELEASE: I agree that if my dependent or I (heretofore known as “we”) engage in any physical exercise, class,
______     or activity, or facility on the premises or any venue where we participate as representatives of Encore Dance Studio LLC, we do so at our

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own risk. I agree that we are voluntarily participating in activities and use of said facilities, premises (including the parking lot) and designated Encore Dance Studio venues. We assume all risk of injury, illness, damage, or loss to us or our property that might result, including, without limitation, any loss or theft of any personal property. I agree that this consent and assumption of risk statement covers each and every event or activity sponsored by Encore Dance Studio LLC. I agree to release and discharge you (and your affiliates, employees, agents, representatives, successors, and assigns) from any and all claims or cause of action (known or unknown) arising out of your negligence. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waiving any right that I may have to bring legal action to assert a claim against you for your negligence.

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Signature of Parent/Guardian if minor						Date
	                    Studio Rules
MAKE-UP CLASSES
Remember your child’s progress depends on class attendance and practice at home. Classes missed due to injury, illness or vacation may be made up within four weeks following the absence if the Studio has been contacted beforehand. Call Encore Dance Studio to schedule a make-up class. Your child must make up a class during another scheduled class time within 4 weeks of missed class. There will be no refunds for missed classes!

DRESS CODE

All students are required to wear and bring the following to each class:

For Ballet, Classes: 
Girls: Leotard (skirt optional)
Pink Tights 
Ballet Shoes Pink
Boys: tight fitting t-shirt, black ballet shoes and black shorts, dance pants or tights.
Tap, and Jazz Classes 
Tap Shoes Black Jazz Shoes 
Jazz shorts or pants, Fitted dance top 

For Hip Hop Classes:
Sweats and t-shirt/tank (no jeans)
Tennis shoes – used in studio only. No street shoes.

*	Hair in a ballet bun for ballet.
*	 Hair must be pulled back out of face for all other classes.
*	Label everything w/ student’s first & last name.
*	

RULES FOR STUDENTS

•	No talking in class
•	No chewing gum at the studio
•	Quiet tap shoes when not dancing
•	Keep hands to self
•	Please do not touch the mirrors.
•	No hanging on the bars
•	Ask Teacher before using bathroom
•	No running in the studio
•	No Jewelry
•	Practice daily
•	
No food or drinks in the studio. - water o.k.
•	No street shoes on the dance floor
•	Dance shoes are not to be worn outside so make sure you have other shoes to come and go with.
•	You must stay in the studio until your parent comes to pick you up.
•	No talking/conversations should take place during class. This can be disruptive to fellow classmates on the floor. We can all learn by observing others.
•	Hygiene: Please wash dance wear regularly. Deodorant for students 9 and up. No perfume prior to class, this may aggravate allergies.

*Parents must go over these rules with their child before they begin class.

RULES FOR PARENTS
•	For our teachers to keep your child’s attention in class, we ask that parents wait either in the waiting room or outside the studio. 
•	Please keep the waiting room clean and quiet during classes.
•	Please make sure your child has gone to the bathroom right before class.
•	Your child must be dropped off inside the building, not outside. The parking can get crazy, it is for their safety.
•	Please be courteous to the other students and have your child to class on time. Tardiness detracts from learning and disrupts classmates. 
•	Please do not interrupt the instructors while class is in session. Their time belongs to the students.
•	THERE IS A BULLETIN BOARD AT THE STUDIO WITH IMPORTANT INFORMATION THROUGHOUT THE YEAR.  Please make sure that you check it at least twice a month. 

•	For the safety of your child and courtesy of the teacher and other classes, please be sure to pick up your child promptly.
•	Please remember to look for new letters in your email.
•	 Parents are not allowed to enter ongoing classes as this creates a distraction and may frighten younger dancers. If you have a concern, please ask the front desk to pass a note onto the teacher.
•	Performances: We hold two shows a year. A June recital and one on December, dates TBA. We also participate in community events throughout the year.
        Our dance year consists of at least 45 weeks of lessons plus rehearsals and recitals. Please note that the months with five lessons more than compensate for any months with fewer than 4 lessons due to holidays.
       
         No food or drinks (except water) is allowed in the studio.
         Please enjoy them outside.

					Statement of Understanding
Please read the following. This statement is required for your dancer to dance at Encore Dance Studio LLC Your initials on this form and signature on the registration form acknowledge that you have read, understood, and agree to abide by these statements.

 	I understand that Encore Dance Studio LLC charges a non-refundable registration fee of $30 for new and returning students.  This fee is due at registration. An annual registration fee of $15.00 for continuing students is due at the beginning of each year. 

 	I understand that tuition is due in the studio on the 1^st of each month and is considered late by the 7^th made payable Encore Dance Studio LLC. (Please write dancer’s name and class in the memo of your check, or on the envelope if paying by cash.  If this information is missing, your account will not be credited.)

          _I understand that I will be charged a $10 late fee for all tuition that arrives after the 7^th of each month. This includes checks that are declined. If payment is received after the 15^th, the late fee of $15 will be charged. 

______I understand that there will be a $25 charge for any returned checks. After 2 returned checks, I will be required to pay all monies due in cash or money order.

 ______I understand that all lost and found items will be donated after 30 days.

           I have also read and understand all the Studio Rules and have gone over them with my child.

 ______I understand that my child is to abide by the dress code set forth in the Studio Rules.

 ______I understand that I must contact the Studio before my child’s scheduled class to arrange for any make-up classes and that all make-up classes must be completed within 4 weeks following the absence. I also understand that there will be no refunds for missed classes.

 _____I understand that I must give the Studio a 30-day written notice if my child needs to drop out of classes taken at Encore Dance Studio LLC. (Temporary absences due to injury, illness, family emergency, etc. may be discussed with the front desk).

_____Please take valuables such as wallets and cell phones with you. We are not responsible for lost/stolen items. Please turn off cell phones prior to entering class. Cell phones are a distraction.

_____Encore Dance Studio LLC does not carry medical insurance for its students. It is required that all dance students be covered by their own family insurance policies and if injury occurs it is understood that the student’s own policy is your only source of reimbursement.

______ Parents are welcome to drop their child off for dance class. Parents may want to stay for young children in combo classes. Please be on time to pick up your child after class. If parent is late, more than 5 minutes after your child class has ended, you will be charged $1.00 per minute to pay for the teacher or manager to supervise your child. This charge will be added to your bill.

______We have viewing windows in the lobby so that parents may watch class. Please be careful of conversation topics because there are many “little ears” around. Please do not talk about adult topics, other dancers or parents, or instructors. This is not appropriate for the lobby area. If you have a problem regarding the instructors, other students, or parents, please see the front to discuss it. By talking about it in the lobby you are undermining the instructor’s authority or hurting the feelings of other dancers and their parents. Please help us to promote the most positive environment and make everyone feel welcome.

______ All costumes and Encore Dance Studio and Company logo wear/bags must be purchased through the studio unless asked to do otherwise.  No unauthorized use of our logo is permitted.  

______ Parents are responsible for monitoring all siblings not in lessons. No running, yelling or rough playing at the dance studio. Parents and siblings are asked to wait quietly in the lobby, students in class can hear conversation in the waiting rooms please be as quiet as possible.  Only students are allowed in the dance rooms. 

_______ Dancers are expected to be at class on time and prepared for dance. Instructors reserve the right to dismiss any dancer from class whose attitudes are unsatisfactory. Encore Dance Studio promote all dancers to treat each other with respect, support, and encouragement.