Studio 84 School of Dance 2018-2019 REGISTRATION FORM Student Name: Age: Date of Birth: Grade (2018-2019 school year) : School Attending: Male Female Address: (Street Address) (City) (Zip Code) Mother s Name:_Father s Name:_ Home Phone: Mother s Cell: Father s Cell: Email Address: (This is how we contact you throughout the year. You can give more than one email address if necessary!) Emergency Contact (other than parents): Phone #: The 2018-2019 Dance Session will be my year of dance. Previous Teacher: (This is for awards at the end of the year. Accuracy is your responsibility) If your child has any allergies and/or medical conditions, please list them: Please list any siblings that are also enrolled at Studio 84: How did you hear about us? I AM / AM NOT not interested in becoming a stage mom for the dance revue CLASS INFORMATION: Combination Class Tap/Ballet/Jazz ages 3-11 Hip Hop Ages 6 & up Extra Ballet Ages 7 & up Twice/week class Ages 12 & up I would like to register my child for one of the following: Combination Class ONLY Combination Class and Extra Ballet Combination Class and Hip Hop Combination Class, Extra Ballet and Hip Hop Mommy & Me (Ages 1 ½ - 3 and moms) Ballet ONLY (ages 7 and up) Twice/Week Class Twice/Week class and Hip Hop Pointe (age varies per student) Contemporary (ages 9-12) if there is enough interest Contemporary (ages 13 and up) I do hereby release Studio 84 School of Dance and its representatives, whether paid or volunteer, from any liability that my child may incur during his or her participation. I have read the 2018-2019 Policy Sheet and agree to abide to the rules and regulations. _ (Student Signature) I DO / DO NOT grant permission to Studio 84 School of Dance to use my image or that of my child on social media, in advertisements, or in other studio publications. OFFICE USE ONLY Registration Fee Paid: Family Registration Fee Paid: Cash/Check Receipt/Check #:
NEW HEIGHTS GYM WAIVER OF RESPONSIBILITY AND MEDICAL RELEASE In consideration of being accepted as a member of New Heights Gym, I agree to abide by the rules of this organization and all applicable by-laws of USA Gymnastics and/or USA Track & Field and/or AAU. GYMNASTICS, TUMBLING, DANCING, CHEERLEADING, KARATE AND POLE VAULTING ARE POTENTIALLY DANGEROUS SPORTS AND CAN LEAD TO INJURY. I understand that New Heights Gym, LLC has an obligation to make the students and their parents aware of the risks and hazards associated with the sports of gymnastics, tumbling, cheerleading, karate and pole vaulting. I understand that as a parent, I am responsible in making my child aware of the possibility of injury and to encourage my child to follow all safety rules and the coaches instructions. Students should never engage in activity without supervision. Students should wear appropriate attire for all activities. Clothing, whether too baggy or too tight, can impede movements and reduce safety. Students should not wear jewelry and should have hair under control so that vision is not impaired. Students should report to the coach anything that will compromise their ability to perform, such as being ill, angry, fatigued, frustrated, or on medication. Students should be able to communicate their comfort level with skills as they are presented and mastered. Students should not pursue skills or activities that exceed their current abilities. I assume full responsibility for my own safety and the safety of my child, understanding and accepting the risks involved with the sport and training of gymnastics, tumbling, cheerleading, karate and pole vaulting. I agree not to bring any claim or suit against New Heights Gym, LLC, the owners, instructors, staff, guests, students, or any other parties on my behalf or on behalf of my child for any injury or harm sustained by any event short of criminal act, and then only the criminal shall be the subject of that claim or suit. I further agree that I will not cause to be brought, nor encourage a claim or suit. I also agree not to cooperate in the bringing of such a suit or claim, except insofar as I may be legally required to do so. Finally, I shall indemnify New Heights Gym, LLC, the owners, instructors, staff, guests, students, and any and all additional defendants covered by this agreement for all judgments, costs, attorney fees, and other expenses incurred as a result of a breach of this agreement. New Heights Gym, LLC, its owners, coaches, and other staff members will not accept responsibility for injuries sustained by a student during instruction, or open workouts, or in the course of any exhibition, competition, or clinic in which the child may participate or while traveling to or from the event. With the above in mind, and being fully aware of the risks and possibility of injury involved, I consent to have my child participate in the programs offered by New Heights Gym, LLC. I waive and release all rights and claims for damages that my child or I may have against New Heights Gym, LLC or its representatives whether paid or volunteer. I understand that New Heights Gym, LLC staff members are not physicians or medical practitioners of any kind. I, the undersigned, give the instructors, staff and responsible adults the power to authorize medical or other treatment of the student named below. I understand that the instructors, senior students, or others may have some skills in first aid, CPR, and, at their discretion, I authorize them to use those skills and techniques to assist in any circumstances in which they judge their skills would be necessary or helpful. I hereby release New Heights Gym, LLC staff to render first aid to my child in the event of injury or illness, and if deemed necessary by New Heights Gym, LLC staff, the calling of an ambulance for the said child. Parent s Signature: Date: Student s Name:
Registration Information Early Bird Registration Rates: Registration/Insurance fee: $65.00 (non-refundable) **Family Rate** Registration/Insurance fee: $95.00 If received after June 16 th, Registration/Insurance fee: $85.00 If received after June 16 th, **Family Rate** Registration/Insurance fee: $115.00 In order to reserve your child s spot at our studio, please return registration form, registration fee*, and New Heights Gym waiver to the studio on or before Registration Day: New Student Registration Saturday, June 16 th 10:00-2:00 Studio 84 School of Dance Existing students can mail forms to: Studio 84 School of Dance 1204 Import Drive, Suite A New Iberia, LA 70560 (Forms must be received before June 16 th ) *Please make checks payable to Studio 84 Class Information Students will be placed in classes by age and ability. Changes will be made when necessary. All decisions are made solely by the teacher. Advanced level classes will be required to take a jazz/tap/lyrical combination class AND a separate ballet class. Tuition will not be pro-rated to exclude ballet. Ballet is the core of dance education and it is required of all upper level students. These students will be in the twice a week class category. Our tuition schedule is as follows: MOMMY & ME CLASS...$50/MONTH 45 min. to 1 HOUR CLASS...$55/MONTH 1 HOUR 15 MIN CLASS...$60/MONTH 1 HOUR 30 MIN CLASS...$65/MONTH TWICE/WEEK CLASS...$75/MONTH BALLET...$50/MONTH (as an ONLY class) PRIVATE LESSONS...$50/HOUR EXTRA CLASSES FOR STUDENTS ENROLLED IN COMBINATION CLASSES ARE AS FOLLOWS: ADD HIP HOP (ages 6 and up)...add $15/MONTH TO TUITION ADD EXTRA BALLET (ages 7 and up)...add $15/MONTH TO TUITION ADD POINTE (at ballet teacher s discretion)...add $10/MONTH TO TUITION ADD CONTEMPORARY (ages 12 and up)...add $15/MONTH TO TUITION **We no longer offer Hip Hop Only classes** After we have received your child s registration form, you will be sent all of his/her class information including class days and times, monthly tuition, all expected expenses for the year, required shoes, etc. You should be receiving this information in July. If you have not received any information by August 20 th, please contact the studio. Classes will begin on Tuesday, September 4 th, 2018. Thank you for choosing Studio 84 School of Dance for your child s dance education. If you have any questions, please feel free to contact the office at (337) 321-4044 or at studio84schoolofdance@yahoo.com. We look forward to teaching your children! -Mrs. Stephanie & Staff
I. TUITION/FEES Studio 84 School of Dance Policy Sheet 2018-2019 Tuition is due by the 1 st of each month. A $20.00 late fee will be applied to payments received after the 15 th of each month. If the late fee is not received with your payment, the $20.00 late fee will be charged to your account. All tuition checks must be payable to Studio 84. Statements will be emailed the first week of each month. Please make sure we have your correct email address. If you do not have an email address, it is your responsibility to check with the office monthly. You can now pay with our online payment portal. There is also a link on our website. Payment portal: https://app.thestudiodirector.com/studio84schoolofdance/portal.sd There will be a $25.00 NSF charge for all checks returned to Studio 84 School of Dance. Dance Sessions will run from September through May. All Holidays and emergency days recognized by the Iberia Parish School Board will also be kept by our studio, unless you are otherwise notified. No credits or refunds will be given for class not attended. All charges, including revue fee, costume fees, and May tuition will be due prior to the dance performance. Failure to pay these fees will result in your child not being allowed to participate. In the event that a student needs to drop, you have until November 1 st, 2018 to let the office know. After this date, you are responsible for all fees and tuition for the remainder of the year. Any fees paid prior to dropping are non-refundable. II. DRESS CODE The following dress code will be strictly enforced: (You will receive a list of shoe requirements after registration) All students must wear dance clothes to all classes. COMBINATION CLASSES: Any leotard & dance tights. Ballet skirts, jazz pants or shorts & dance tops are acceptable. They are to fit the body snug and should not be baggy. T-shirts and casual shorts are NOT ACCEPTABLE! Hair should be pulled out of face. EXTRA BALLET CLASSES: Solid black leotard, pink dance tights and pink ballet shoes. Ballet skirts are optional. Hair is to be worn in a bun. HIP HOP CLASSES: Athletic shorts or pants with a fitted dance top or t-shirt and tennis shoes. Dance shoes should not be worn to and from class. All students should have their names written in their shoes. Cover-ups should be worn to and from class. NO GUM!! NO FOOD!! NO JEWELRY!!
III. PERFORMANCE The culmination of our year s dance training will be highlighted by our annual year end performance. You will receive the revue date and additional revue information at the beginning of the dancing year. Costs to cover facility rental, insurance, backdrops, tickets, DVD, etc. will be assessed before the revue. This is called the revue fee. Additional information regarding the performance will be sent to you at a later date. Costume payments will be due in installments. You will be given additional information at the beginning of the dancing year. The costume fee is non-refundable. As we get closer to the dance revue, it is possible that some classes will require extra practice or experience changes in class times. You will be notified ahead of time. All higher level classes will have weekend practices leading up to the dance revue. ANY STUDENT WHO MISSES PRACTICE THE WEEKEND BEFORE THE REVUE WILL NOT BE ALLOWED TO PARTICIPATE IN OUR PERFORMANCE!! Dress Rehearsals are mandatory. Any student who misses without a valid excuse will not be allowed to participate in our performance. Stage moms are needed for dress rehearsals and dance revue. As a stage mom, your responsibility would be to walk the class to and from backstage before and after their dances. If you are interested in becoming a stage mom, please be sure to check the box and circle I AM on your child s registration form. Thank you in advance! We appreciate you more than you know!! IV. GENERAL RULES Regular attendance is mandatory! Missing class not only hurts the individual but it also affects the progress of the entire class. When an absence cannot be avoided, please call or email the studio to let the teacher know! Students should arrive 5 minutes before class begins and should wait outside of the dancing room until the previous class is finished! Students who are waiting to be picked up must wait inside of the lobby. NO ONE is to wait outside! Please be aware that I will often send notes home with your children. Please remember to check their dancing bags to assure that all notes are received. I also send emails periodically. Please add studio84schoolofdance@yahoo.com to your address book. NO CELL PHONES IN CLASS!! Cooperation between teachers, students, and parents will assure a fun and successful year for everyone! -Stephanie R. Gonsoulin Owner/Director