Classes are for ages 3 years old to Adult.  To sign-up for Dance, Acting and Tumbling classes, simply print out the Registration form below and bring the completed Registration Form to the studio or click link to register online at http://www.rhythmelements.com/online-payment  via our website.  Any questions or assistance needed, please feel free to call us at (770) 787-4333.  

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RHYTHM ELEMENTS DANCE STUDIO

                                                                                                               Session: _________________________________

                                                                                                               Sign-up Date: _____________________________

New Student Registration Form

Student Information

Student’s Name: _______________________________ Date of Birth (MM/DD/YYYY): _______________

Mailing Address: ______________________________________________________________________

Primary Phone: ________________________________ Phone (2): _____________________________

Name of Person responsible for paying fees: _______________________________________________

Primary Email Address: ________________________________________________________________

Primary Billing Phone # ______________________________

Legal Release and Policy Acceptance (please initial)

___ I/we understand the Studio Policies                                     ___I/we understand my billing obligations

___ I/we understand the risks related to dance                      ___ I/we understand my responsibilities for my property

___ I/we understand the dress code                                            ___ I/we understand the schedule

___ I/we give media use rights permission                               ___ I/we understand the attendance policy

___________________________________                              ____________________________________

Signature / Responsible Party                                                        Date

Classes

Class Name                                                     Meeting Date(s) / Time                                      Fees / Minutes

_____________________                         ________________________                         __________________

_____________________                         ________________________                         __________________

_____________________                         ________________________                        ___________________

_____________________                         ________________________                        ___________________

Please fill out all that applies:

Registration Fee: _______________                                                                    Showcase Fee: ______________

Tuition: ______________________                                                                      Costume Fee: _______________

Discounts: ____________________                                                                      Comp Fees: ________________

Total Monthly Tuition __________                                                                      Private Lessons Fee:__________

Measurements

_____ Height                      _____ Girth                        _____ Tights Size

_____ Shoe Size                _____ Inseam                   _____  Leotard Size

Medical

Allergies: ____________________________________________________________________________

Will your child require any special medical attention during a normal class: (yes/no) ______________

If yes – Explain: _______________________________________________________________________

[ ] – Recorded    [ ] Paid in full    [ ] On hold Processed by: ________   Special Notes: ________________

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