Registration

DanceWays, L.L.C. Class Registration

* To enroll in classes, please mail this form with a check made payable to

DanceWays, L.L.C., PO Box 190, Huntersville, NC 28070-0190.

Parent/Guardian Name(s)______________________________________________

Address: ____________________________________________________________

Hm/Wk/Cell #: ___________________ Hm/Wk/Cell: ______________________

E-mail: ____________________________________________________________

Student’s Name:___________________________ Birthday: __________________

Years Dance Experience: _______ Last Class Attended: _______ Grade: _______

Type of Previous Experience: ____________________________________________________________

_______ I will allow photos to be taken of my child for the class scrapbook and web site (no names will be used and no photos will be given to another party)
_______ I have read and understand DanceWays, L.L.C. Policies
_______ I have read, signed and understand DanceWays, L.L.C. Waiver
_______ I understand tuition is due the first lesson of each month, a $10 late fee will be assessed after the 15th, and a $20.00 fee is charged for returned checks.

Emergency Contact: ___________________________________________________________________

Relationship to Student: _________________________ Phone #: ______________________________

Student’s Health Insurance Carrier: ______________________________________________________

Student’s Allergies &/or Medical Conditions: _______________________________________________

How did you hear about DanceWays, L.L.C.? _______________________________________________

	Class	Time	Tuition/1 hour class each wk (HFFA member/non member)	Sibling Discount/ Scholarship
X	Registration Fee		$20.00/school year	N/A
	Saturdays, 4-6 yrs	10:30am–11:30am	$40.00/45.00 month
	Saturdays, 6-11 yrs	11:30am-12:30pm	$40.00/45.00 month
	Saturdays, 4-6 yrs	12:30pm–1:30pm	$40.00/45.00 month

I understand tuition is due the first lesson of each month, a $10 late fee will be assessed after the 15th, and a $20.00 fee is charged for returned checks.

Amount enclosed: ___________________________ Check #: ______________________________

Signature: __________________________________ Date: ________________________________