registration form – Dance Factory NYC

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Registration Form

Thank you so much for choosing to be a part of our Dance Factory family. We are so excited to finally be able to get started on our 19th season! Please make sure to read this carefully as we have made a few policy changes.

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Thank you so much for choosing to be a part of our Dance Factory family. We are so excited to finally be able to get started on our 19th season! Please make sure to read this carefully as we have made a few policy changes.

Please check all boxes indicating you understand the new policies.*

- All dance classes will be DROP-OFF ONLY. We’re asking that parents/guardians please Remain Outside of our building. If it is absolutely necessary for you to enter our building we ask that you please keep it to a minimum of one parent/guardian per child.

- Allow us to check the temperature of your children before entering the building, as well as ensure their hands have been sanitized or washed.

- Please adhere to your assigned class time. We have made sure all of our classes are spaced out with enough time for us to sanitize each dance room between classes. We ask that you please allow us that time by ensuring drop off is no more than 5 minutes prior to the start of your dancer’s class.

- All invoices will be sent via email. Please make sure to provide us will an actively checked email while registering. Payments will also be preferred electronically. If it is necessary for a check/cash payment please send your dancer in with the payment during their class time.

- Ticket sales for our annual recital will be held from June 2nd – June 8th. We will be collecting your desired number of tickets as well as the payment for them ($25 each) during that week. We will then select the next best available seats for you and distribute them the week of June 9th – June 16th

Student's First Name*

Student's Last Name*

Student's Full Address*

Home Phone*

Student's Date of Birth*

Parent's First Name*

Parent's Last Name*

Parent's Cell Phone Number*

Email*

Student's Medical Condition (if any)

How Did You Hear About Us?*

Google

Friend/Referral

Facebook

Instagram

Other

How Would You Like To Be Contacted?*

Phone Call

Text Message

Phone Call & Email

ACKNOWLEDGEMENT OF CLASSES & TUITION RATE

PLEASE LIST CLASSES FOR WHICH YOU ARE REGISTERING (DAY & TIME)

Classes interested in are:*

TOTAL MONTHLY TUITION:*

TUITION REFUND POLICY

ALL TUITION AND FEES PAID TO THE SCHOOL ARE NON-REFUNDABLE AFTER THEY HAVE BEEN PAID, REGARDLESS OF WHETHER OR NOT THE PROGRAM IN QUESTION HAS BEGUN.

Signature of Parent or Legal Guardian (Note: Use finger to sign if on a tablet or mobile device)*

Date Signed*

REGISTRATION AGREEMENT

AS THE STUDENT, PARENT, OR LEGAL GUARDIAN, I HEREBY STATE THAT I HAVE READ ALL GUIDELINES OUTLINED IN THE DANCE FACTORY INFORMATION BOOKLET AND ARE IN FULL AGREEMENT WITH REGARDS TO ALL POLICIES. I UNDERSTAND THAT DANCE FACTORY INC. RESERVES THE RIGHT TO MAKE ALL FINAL DECISIONS WITH REGARDS TO: STUDENT PLACEMENT, CHOREOGRAPHY, COSTUME, MUSIC, CLASS SCHEDULES, AND ANY/ALL OTHER ASPECTS ASSOCIATED WITH THIS SCHOOL. I UNDERSTAND THAT NOT ABIDING BY THE DANCE FACTORY GUIDELINES CAN RESULT IN TERMINATION OF ENROLLMENT WITHOUT REFUND OF: TUTION, COSTUME DEPOSITS OR BALANCES, REGISTRATION FEES, AND ANY OTHER PAYMENTS MADE TO DANCE FACTORY. I HAVE READ AND FULLY AGREE TO THE ABOVE STATEMENTS.

Signature of Parent or Legal Guardian (Note: Use finger to sign if on a tablet or mobile device)*

Date Signed*

WAIVER AND RELEASE AGREEMENT

1. I am not aware of any medical condition I have/my child has that should preclude me/my child from participating in dance and/or aerial activities. I understand there is a definitive risk of injury associated with dancing and/or performing aerials, and that such injuries include, but are not limited to bruises, dislocations, broken bones, torn or damaged muscles and ligaments, paralysis, and even death. I understand that such injuries may be caused in whole or in part by myself, or by the actions or inactions of other students or instructors. 2. In consideration of being accepted for dance and/or aerial instruction by Dance Factory Inc. (d.b.a. Dance Factory), and the Owners/Artistic Directors, Nicole D’Agostino, Michelle Caputo, and Lauren Volpe, and in further consideration of the expertise and achievements of instructors at Dance Factory Inc. (d.b.a. Dance Factory), and the limited number of students that may be accepted by Dance Factory Inc. (d.b.a. Dance Factory), I agree to all of the following, which shall bind me, and also my heirs, assigns executors, and administrators: a. I/My child agree(s) to immediately stop performing any activity if I/they feel any pain, dizziness, light-headedness, or any other symptoms, and to immediately report those symptoms to the instructor. I/they also agree to carefully follow the instructors’ directions, to ask for additional directions if I/they do not understand any particular activity, and to immediately stop any activity which I/they believe I am/they are not competent or confident enough to perform. b. To the fullest extent permitted by law, I agree and represent that I assume the risk and responsibility for any and all injuries to myself/my child that I/they sustain while performing any dance or aerial activities, including any and all costs and damages that are a consequence of such injuries, and whether such injuries, costs and damages were caused in whole or in part by the Dance Factory Inc.’s (d.b.a. Dance Factory) students, or instructors, or the Owners/Artistic Directors, Nicole D’Agostino, Michelle Caputo, and Lauren Volpe. c. To the fullest extent permitted by law, I agree to defend, indemnify and hold harmless Dance Factory Inc. (d.b.a. Dance Factory), and the Owners/Artistic Directors, Nicole D’Agostino, Michelle Caputo, and Lauren Volpe, and their instructors, agents, employees, contractors, clients, and students, from and against all claims, costs, damages, losses and expenses, including but not limited to attorney’s fees, arising out of or resulting from my/my child’s performance or other participation in any dance or aerial activities, regardless of whether or not such claim, cost, damage, loss or expense, was caused in part by a party indemnified hereunder. I have fully read and agree to all of the above, and I make this agreement and the representations herein in order to induce Dance Factory Inc. (d.b.a. Dance Factory) and the Owners/Artistic Directors, Nicole D’Agostino, Michelle Caputo, and Lauren Volpe to accept me/my child as a student for dance and/or aerial instruction.

Name of Student*

Date*

Signature of Parent or Legal Guardian (Note: Use finger to sign if on a tablet or mobile device)*

Date Signed*