registration form Form Submission is restrictedForm is successfully submitted. Thank you!Registration FormThank 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.Step1Step2Step3Step4Step5Step6Thank 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 20th 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.*- Tuition for the month is due on the first of every month. Payment still due and mandatory even if you miss class. No credit or adjusting tuition.- Costume deposit are $80 per costume and are due by November 15th. If payment isn’t in, costume will not be ordered.- Costume Balance cost is TBD and is due by January 15th.- You are required to purchase a minimum of 5 tickets per dancer/7 per family for our recital.- Agree to leave all creative decision and class placement up to Dance Factory.- Picture days are required but not obligated to purchase.- Classes are pick-up & drop-off only* NO parents in the building whatsoever. Thank you for your cooperation.- If you no longer wish to participate in program please send it in writing to avoid payment issues.- Please download our calendar and schedule.* Subject to change any time during the year. 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?*GoogleFriend/ReferralFacebookInstagramOtherHow Would You Like To Be Contacted?*Phone CallText MessageEmailPhone Call & Email ACKNOWLEDGEMENT OF CLASSES & TUITION RATEPLEASE LIST CLASSES FOR WHICH YOU ARE REGISTERING (DAY & TIME)Classes interested in are:*TOTAL MONTHLY TUITION:* TUITION REFUND POLICYALL 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.Tuition for the month is due on the first of every month. Payment still due and mandatory even if you miss class. No credit or adjusting tuition.Signature of Parent or Legal Guardian (Note: Use finger to sign if on a tablet or mobile device)*Date Signed* REGISTRATION AGREEMENTAS 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 AGREEMENT1. 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* Submit
