DAY/TIME/TYPE of Class (Some classes fill early-if no space exists you will be contacted promptly and fully refunded).

 _____________________________________________________________________________________________________  

 

List IMPOSSIBLE  Day/s or Times:_____________________________________________________________________________________

 

Child's Name: __________________________________Age by 1^st Class: ____ Birth Mo/Day/Yr:   _____/______/_____

'07-'08 School: _______________________________'07-'08 Grade: _______ PRUMC Member? Yes____ No ____

 Home Address: ______________________________________ City: _____________________ Zip: _____________

 List pertinent health info on separate page & attach: allergies, asthma, required medications, learning problems, etc.

 Mother's Name: ____________________________ Home Phone No. (          ) ____________________________

 Mom's Cell No. (          ) ______________________ Mom's Work No. (         ) ____________________________

 Father's Name: _____________________________ Dad's Work No. (          )_____________________________

 Dad's Cell No. (          ) _______________________ Home FAX: _______________________________________

PLEASE PRINT: Family's e-mail:________________________________________________________________

Please keep your contact info updated in case of emergency!  If billing address is different, please attach a note clearly stating your needs.

May a photograph of your child be used for publicity if she/he is not identified by name? Circle:  Yes   No

·                   Registration is 1^st come, 1^st served!  No FAX or phone reservations! Need-based scholarships available: 404-375-7280.

·                   DancerKids, Inc. Calendar is available at your first class! Note: Dance dates usually differ by age/class, and may not match your School’s, or even other PRUMC Rec. programs!   

·                   Make-ups are scheduled only if teacher must be absent from class, or if student has prolonged serious illness or injury.

·                   For students who perform only 1 time per year in the Spring Recital: tuition is based on 24-27 weekly 45-55 min. lessons per yr.  

(varies by age), with one recital dance for Spring Recital, 1Recital costume included in tuition.

·                   Gr. 2-12 “Company”-students who perform 3-5 times annually (Holiday & Spring) in:  tuition based on 33-36 weekly, 75-90 min. lesson/rehearsals, 3 dances min. per yr. for extra performances, and  includes 1 leotard and skirt or jazz pants as base costume.  Co. parents will be billed separately in Fall and Winter, as necessary, for additional costume pieces, accessories, or props.

 

                                                      WAIVER OF LIABILITY AND RELEASE_________________________

I recognize that there are inherent risks involved in dance and fitness activities. In consideration of the services provided, I hereby release and hold harmless, DancerKids, Inc., Peachtree Road United Methodist Church, and its Department of Sports, Recreation and Life Enrichment and both organization’s Directors, employees and agents from any and all liability for injuries, including those resulting in death, and illnesses incurred while participating or attending any event or in any facility of Peachtree Road United Methodist Church. By signing this document, the adult participant, or parent or legal guardian of a child participant confirms that he or she has authority to sign, has read the entire document, and has understanding that the document waives certain rights of the person signing or the participant.

 

Print Parent's Name:____________________________________________________________________________________

    Signature: __________________________________________________   Date: ___________________________

Please List Your Check No:________________ List Payment Amount Enclosed: _________________(Tuition Details On Reverse)

 

Ø             Sign Release and MAIL this form with check payable to:  DancerKids, Inc., 400 Elden Drive, Atlanta 30342.

 

 

SPECIAL REQUESTS: Be ready to register immediately after contacting Jan Duffy about current availability, or spaces discussed may disappear! To insure that your child will have a space, please remember to list your “Impossible” day/s and time/s (if any), not only your preferences, in case your 1^st choice is unavailable!  If no space exists you will be fully refunded!  No space can be reserved without ’07-’08 Dance Registration Form & tuition deposit-(a list of names, or a phone call to Jan Duffy is not enough to hold any space for any student)!

 

 

2007-2008 TUITION

(no credit cards accepted)

(Please Read Carefully to Select Correct Fee & Payment Schedule for YOUR Class): 

· “Recital Only” Classes (45-60 min. weekly for Ages 2-13; fee includes 1 Recital costume; 1 Spring Recital dance): $400 per year if registered by May 31; or $150 at registration and $150 due by 10/31 and 1/31.

· “Company” Classes (Gr. 2-8; more classes; longer class period; min. of 3 dances for extra performances; some costuming): $ 650 per year if registered by May 31; or $250 at registration and $250 due by 10/31 and 1/31 ( or call to arrange other payment plan).

“High School Company” Scholarship Tuition (Recommended for Experienced Dancers in Grades 9-12):  400 per year if registered by May 31; or $250 at registration and $250 due by 1/31.

 

REFUNDS:  NO SPACE IN CLASS=FULL REFUND ASAP!  For all other withdrawals:  The amount equal to the first tuition payment (minimum), is non-refundable, (even if no classes were attended, as a space was held for your child that we could not make available to other students).  Refunds for all withdrawals require 30 Days Advance Notice, in Writing!  A record is made of the date the written refund request is received in order to correctly calculate the amount to be refunded.  Email: dancerkids@aol.com, or mail to: 400 Elden Drive, Atlanta, GA 30342.