Registration


Fall 2017 Schedule

Summer Camps 2017


Registration Form

Please complete the form and a member of our staff will contact you shortly to confirm your enrollment.  For more information please call the office.

 This is a REQUIRED filed and must be filled in, or could result in delaying the registration process.

Registering For:*

Phone Number*
Student’s Name*
D.O.B.*
Age*
Address*
City*
State*
Zip*
   
Parent’s Name*
Parent’s Email*
Emergency Contact         Relation:
Emergency Number
Email Address
   

 

  Dance Class Number Class Day & Time Class Title
1.
2.
PARENT AGREEMENT: I, as the parent/guardian of the above student, understand that all fees associated with participating in the above mentioned classes are due no later than the first day of each month of the season.  I also understand that if payment is received after the 5th day of the month, there will be a $15 a late fee charged. 

If a check is returned, there is a $25 returned check fee, and if two or more checks are returned, I will be required to submit any further payments in the form of a certified check, money order, cash or by credit card (auto withdraw).

I understand, all monies paid, are nonrefundable and nontransferable. As the parent/guardian of a minor participating in classes and/or activities at St. Peters Academy of Dance, I acknowledge that there is an assumed element of risk and therefore assume all risks and hazards incidental to the participation, and hereby release, resolve, indemnify and agree to hold harmless, St. Peters Academy of Dance (SPAD), its agents, employees, officers, and volunteers.  Neither SPAD nor said personals shall be held financially responsible for any injury, illness, or death, incurred as a direct result or indirect result of this activity.  I also grant permission to use the above mentioned student’s name, photograph, video tape, or recording for any promotional purposes without any obligation to me or my family and without written consent.

After submission of this form,  you will be redirected to a “Complete Your Registration” page and pay the $10.00 Registration Fee NOW.
(NOTE: $10 registration fee is non-refundable)