Seacoast Dance Registration Form

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Renweb ID#: 2017-2018 Seacoast Dance Registration Form Student s First & Middle Name: Last Name: Student Gender: DOB: Grade Level: School: Parent/Guardian Name: Renweb ID#: #1 Contact First Name: Last Name: Type: Home Phone: Cell #: Work #: Email: Employer: Employer Phone: #2 Contact First Name: Last Name: Type: Home Phone: Cell #: Work #: Email: Employer: Employer Phone: Home Address: City: State: Zip Code: Emergency Contact: Phone: Medical Conditions: Allergies: Special Needs: Medications: Primary Doctor: Phone: Who is allowed to pick you your child? ** No child will be able to leave with anyone not on this list without prior written notification.

Renweb ID#: Student s First & Middle Name: Last Name: Classes You Are Registering For: Class: Day: Time: Tuition: Class: Day: Time: Tuition: Class: Day: Time: Tuition: Tuition and Pricing: Classes are weekly. Each additional class price is for additional class or immediate member of family. You must please pay your dance teacher directly and not the pre-school. Classes are weekly. Each additional class price is for additional class or Immediate Family Member. TUITION Registration Fee $15 Student / $25 Family PreK Dance Classes 2, 3, 4 yr old 1 Class per week - $40.00 / month Kindergarten-5 th Grades September 2017 Discounted October 2017 May 2018 Regular Tuition Tuition 1 st Class - $45.00 / month 1 st Class - $55.00 / month 2 nd Class - $65.00 / month 2 nd Class - $75.00 / month 3 rd Class - $85.00 / month 3 rd Class - $95.00 / month 4 th Class - $105.00 / month 4 th Class - $115.00 / month Unlimited - $125.00 / month Unlimited - $135.00 / month **Please make checks payable to Michelle Maso** Cash and credit card payments accepted in the studio only

Renweb ID#: Student s First & Middle Name: Last Name: IMPORTANT: Tuition is based on a monthly rate and not the number of classes in a month as this will vary from month to month. Students usually receive an average of 39-42 classes per season. Classes are weekly but tuition is figured monthly. Tuition is automatically charged on the 1 st of each month (August-May). A late fee of $15.00 is charged to accounts not paid by the 10 th. A 5% discount is applied to accounts who pay for the entire year in full by September 15 th, 2015. This payment is NON-REFUNDABLE. Monthly Tuition is NOT pro-rated for missed classes. We offer make-up classes for these occasions but they must be scheduled in advance with teacher. Tuition is non-refundable. All withdrawals must be received in writing prior to the 1 st of the month in order not be charged for that month. We do not accept verbal withdraws. We do not generate monthly invoices. We accept major credit cards on an event basis or as a monthly draft. A $40.00 fee is charged on all returned checks. When making a payment by cash or check, please include the first and last name / s in the memo of your check, so we may credit the proper account. We can accept cash & check payments as long as they are paid prior to the due date. Any account unpaid after the (10 th ) tenth of the month, even those who auto-draft come back declined, will have late charges assessed for $10.00 of the total monthly tuition. Any student with an overdue balance of more than 60 days will not be allowed into class until payment in full is received or payment arrangements have been made. Credits will not be given for missed classes due to illness, inclement weather, or personal commitments. If your dancer misses class due to illness or other personal reason, they will be able to make up in a similar class up to 3 allowed per dance season. Recital Policies: We produce a Christmas and year end program at the end of the season with all dancers participating. This is an exciting and rewarding part of the season that everyone looks forward to and we encourage all dancers to participate. Recital Costume and recital fees per class to be announced. Costume payments are non-refundable. If your costume fees are not paid in full by the deadline, they will not be ordered. Any alterations needed will be the responsibility of the parent.

Renweb ID#: Student s First & Middle Name: Last Name: Release of Liability Policies: As the legal parent or guardian, I release and hold harmless Seacoast Dance Academy, Seacoast Christian Academy, its owners, teachers and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and / or the undersigned, while in or up the premises or in route to or from any of said premises. I understand that appropriate physical contact is required during the instruction of dance and acrobatics and I give permission for instructors to make appropriate contact with me or my child for such instruction. Medical Emergency Policies: As the legal parent or guardian, I give permission to Seacoast Dance Academy, Seacoast Christian Academy, its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical / mental problems, restrictions, or conditions and / or declare the participant to be in a good physical and mental health. Photo Release and Agreement: I give permission for Seacoast Dance Academy, Seacoast Christian Academy to take pictures and or videos of classes, rehearsals and / or performances, including dancers of Seacoast Dance Academy, Seacoast Christian Academy in costumes of me or my child while participating in dance activities for promotional purposes. I understand that I am giving permission to use these photos and / or videos for publishing use, in printed or electronic format. General Studio Rules: Absolutely no food or drinks in the dance studio. Water only please. No cell phones allowed in the dance studio at any time. If they are in your bag, they should be turned off. All dancers personal belongings may be kept in the studio during class. We are not responsible for items left in the building. Please label ALL of your belongings esp. dancers shoes. No parents, friends, or siblings in the class room at any time. This is for the benefit of your dancer. They will learn more if we have their complete attention. If you need to speak with your child s instructor, please call or email us to set up an appointment as we do not have time between classes. Please complete separate Registration Form for each family member.

VOLUNTEER OPPORTUNITIES IN DANCE At SCA Dance we have something for everyone who is interested in putting in some volunteer hours. From stage hand work, to sewing costumes or carpentry work, we can keep our friends busy! Please check the areas you'd like to volunteer and return with your student to school. The following list is a sampling of some activities we often seek volunteers for: Costumes (ongoing) - Assist in the procurement and/or creation of performance costumes, cataloging, costumes, washing costumes. Sewing is not a prerequisite. Costumes - Sewing/costume repair and alterations Flower Concessions (ongoing) - Assist at performances to sleeve flowers, create small bouquets, and handle sales prior to the start of each performance and during intermissions. Food Concessions (ongoing) - Assist with set-up prior to the performance and sales before performance and at intermission. Hospitality (ongoing) - Volunteers needed to serve meals to students before performances. Food donations for meals before performances and concerts Provide cookies, brownies and sweets for receptions Set up and serve refreshments at performances. Transporting heavy set pieces/pickup truck drivers or providers Light carpentry work for sets Runner during performances Stage hands Provide cases of drinking water for dancers during rehearsals and performances Box office assistants Ad sales Distributing posters around the region Ushers/ticket takers Fundraising (ongoing) - throughout the year there will be opportunities to raise money for school trips, guest teachers, costumes, sets. If you don't see your skills or talents represented above - call us!! We might have just the thing for YOU!! Student Name: Parent Name: Best Contact Number: Email:

DANCE BAG SEACOAST DANCE ACADEMY DRESS CODE 17/18 Students must have a separate dance bag for all dance-wear. Students will not be allowed to carry dance-wear in their book bags. Students must have their name on everything. BALLET - Solid color leotard Spaghetti Strap with low back (for classroom) - Ballet Pink Seamed Convertible Tights - Euroskins by Eurotard - Pink Split Sole Leather or Canvas Ballet Shoes - Bring new shoes into class for teacher to approve fit. Teacher will give final approval. - Nude camisole leotard with adjustable clear straps (low back) - Hair in Bun - Solid color dance shorts - Black 12 black wrap skirt (made by Theatricals) - Dancers pull on shrug or sweater LYRICAL, BALLROOM, JAZZ, CARDIO DANCE, ACRO - Solid Color Leotard any style - Black Jazz Pants or Capri Pants (microfiber) Black Convertible Seamless Tights Bloch Neoflex Tan Jazz Shoes for Jazz - Angelo Luzio Twyla Tan Leather or Canvas Half-sole Shoes for Lyrical and Modern - Black Ballroom leather and suede sole Sandal by DSOL (childrens size 11-4.5) Adult Shoe - Very Fine Shoes Ladies Practice/Cuban- Classic Ballroom Shoes (discountdance.com) TAP Tan Tap Shoes.any style (preferably taps with screws & not nails) BOYS DRESS CODE: - Black Jazz Pants - Snug white Tee Shirt - Black Split Sole Ballet Shoes - Dance Belt - Black Jazz Shoes - Black Tap Shoes Merchandise may be purchased at: Dance n Stuff Boutique Make Believe Costumes & Dancewear 8011-8 Merrill Rd. 1855 Parental Home Road Jacksonville, FL 32277 Jacksonville, FL 32213 904.743. 6080 904.645.6337

8057 Arlington Expressway, Jacksonville, FL 32211 Mrs. Michelle Maso 904-894-1871 2017-2018 Seacoast Dance Academy Schedule Classes subject to change due to enrollment Monday Tuesday Wednesday Thursday Friday Saturday 4:00-5:00 BALLET 5-6 yrs. 5:00-6:00 JAZZ/TAP 5-6 yrs. 4:00-5:00 BALLET I/II 7-9 yrs. 5:00-6:00 JAZZ/TAP 7-9 yrs. 4:00-5:00 BALLET 10-12 yrs. 5:00-6:00 LYRICAL 10 12 yrs. 4:00 5:30 * BALLET/ JAZZ/TAP COMBO 7-12 yrs. 6:00-6:45 BEG. ACRO 5 and Up 6:00-6:45 ACRO 7-12 yrs. 6:00-6:45 BALLROOM/ LATIN/SWING 10 17 yrs. CLASSES BEGIN WEEK OF AUGUST 14th 2017 * Friday Combo class requires enrollment of at least TWO weekly classes (Ballet, Tap, Jazz and/or Lyrical) to be eligible. TUITION Registration Fee $15 Student / $25 Family August 2017 Discounted Tuition September 2017 May 2018 Regular Tuition 1 st Class - $45.00 / month 1 st Class - $55.00 / month 2 nd Class - $65.00 / month 2 nd Class - $75.00 / month 3 rd Class - $85.00 / month 3 rd Class - $95.00 / month 4 th Class - $105.00 / month 4 th Class - $115.00 / month Unlimited - $125.00 / month Unlimited - $135.00 / month **Please make checks payable to Michelle Maso** Cash or Credit Card payment accepted in the studio only

Seacoast Dance Academy Studio Holiday s 2017/2018 September 4, 2017 Labor Day November 23-24 Thanksgiving Break December 21-January 8 Christmas Break (class resumes Tuesday, January, 9, 2018) February 19, 2018 President s Day March 19-23 Spring Break March 30, 2018 Good Friday May 28, 2018 Memorial Day