Contact | Directions


Fall 2016–2017 Registration Form

To register online, please fill this form out completely. Your credit card will not be charged until you hit the “Submit Registration” button on the last screen.

If you would rather fill out a paper form and bring it in or mail it to us, Click HERE to print out a pdf version of this form.

SAVE $35! We'd love to refund your registration fee! Enroll prior to August 15, 2015, remain enrolled through at least December 1, 2015, and authorize payment using our Recurring ACH process (complete our ONLINE FORM or return THIS FORM) and we'll refund your $35 Registration Fee. (one discount per family)

If you've registered previously and would like to use your same information, enter your email address here:

NOTE: If you have more than one dancer, you must fill out a separate registration form for each one.

DANCER’S INFO
Dancer's Name First:   Last: 
Date of Birth (mo/day/yr) / /
Address (incl. apt. #)
City   State   Zip
Family E-mail address
PARENTS’ INFO
Required if dancer is under 18 and/or still living at home.
Parent 1 Name First:   Last: 
Parent 1 Phone Numbers Home:   Work:   Cell:
Parent 2 Name First:   Last: 
Parent 2 Phone Numbers Home:   Work:   Cell:
EMERGENCY INFO
This information is used in the event that we CANNOT reach a parent.
Emergency Contact Name First:   Last: 
Emergency Contact Phone
Relationship to Dancer
Doctor’s Name First:   Last: 
Doctor’s Phone
NOTES

Please enter any notes, requests, or comments you have for us.

CLASSES DESIRED

Please click the checkbox(es) to indicate desired level.

PRESCHOOL and PRIMARY
Cost: $97 for 1 class/week, $169 for 2 classes/week, $216 for 3 classes/week. These fees represent 12 weeks of classes. (Costume/production fees not included here. They will be invoiced separately for those interested in performing.)

Attention: please place a “1” in the yellow box to indicate 1st class choice, a “2” to indicate second choice.

PRESCHOOL
PS Dance Mix
Mon 2:00pm, 25 min. (2.5-3yrs)    Tue 10:00am, 25 min. (2.5-3yrs)    Thu 10:00am, 25 min. (2.5-3yrs)    Sat 9:30am, 25 min. (2.5-3yrs)   
Tiny Tumblers
Mon 2:30pm, 25 min. (2.5-3yrs)    Tue 10:30am, 25 min. (2.5-3yrs)    Thu 10:30am, 25 min. (2.5-3yrs)    Sat 10:00am, 25 min. (2.5-3yrs)   
iMakeMusicMove
Preschool Boppers $0
Preschool Boy O Boy $0
PRIMARY
PR Ballet
Mon 3:00pm, 25 min. (PR Ballet Beats: 4-6yrs)    Thu 3:00pm, 25 min. (PR Ballet Beats: 4-6yrs)    Sat 10:30am, 25 min. (PR Ballet Beats: 4-6yrs)   
PR Tap
Mon 3:30pm, 25 min. (4-6yrs)    Thu 3:30pm, 25 min. (4-6yrs)    Sat 11:00am, 25 min. (4-6yrs)   
PR Hip Hop
Mon 4:00pm, 25 min. (4-6yrs)   
PR Acro
Mon 4:30pm, 25 min. (PR Acro/Tumbling: 4-6yrs)   
Primary Boppers $0
ENRICHMENT
Fees below represent 12 weeks of classes/lessons. Except where indicated with an NP or an OP, Fees below also include costume/tights and production fee. [1 pair tights per costume].
BoyOBoy   (Grab 5 friends & give us a call – we’ll pick a day just for you!) $0
Acro  
  • Returning Acro students will receive Fall Placements via e-mail early August. If you are new or registering prior to placement announcements, simply select "request placement" below.
(Request placement)   Tue 3:00pm, 85 min. (Copper (generally ages 6-10yrs))   Tue 4:30pm, 85 min. (Zinc/Brass (generally ages 10+yrs))   Tue 6:00pm, 115 min. (Chrome (placement required))  
$340
Tap  
Mon 4:00pm, 85 min. (Opal/Topaz)    Mon 5:30pm, 85 min. (Emerald/Garnet)    Thu 5:00pm, 55 min. (Pearl 6-8yrs)   
$340
Jazz  
Wed 4:00pm, 85 min. (Opal 8-10yrs)    Wed 4:00pm, 85 min. (Garnet)    Wed 5:30pm, 85 min. (Emerald)    Wed 7:00pm, 85 min. (Topaz)   
$340
Hip Hop   OP (Option to Perform! Costume & Production Fee invoiced separately for those interested!)
Thu 3:30pm, 55 min. (BBoyz/HipHop (7-11+yrs))    Thu 4:30pm, 55 min. (HIPHOP (10-Teen))   
$180
Ballet
Thu 4:00pm, 55 min. (Pearl (6-8yrs))   Wed 5:30pm, 85 min. (Opal/Topaz (9-13+yrs)) Wed 7:00pm, 85 min. (Emerald/Garnet (Ages 14+yrs))
$340
  Ballet (Non-performance — no costume)
$0
Tech   NP (Non-Performance)
Mon 5:30pm, 85 min. (Opal/Topaz)    Mon 7:00pm, 85 min. (Emerald/Garnet)   
$271
Kids Groove
Mon 3:00pm, 55 min. (Level I (7-11yrs))   
$250
Stage Dance Styles
$340
Jr Combo  
$33
Theater Dance
$33
Lyrical
$0
Open Acro (*Non-performance — no costume)
$0
CODA

CoDa's MONTHLY INSTALLMENT FEE INCLUDES: weekly class AND weekly rehearsal AND production fee (expect separate costume/performance gear invoice in Sept).

  1. Check box on the left.
  2. Select a Ballet, Jazz, Acro, Tech, or Stage Dance Styles class above.
Mon 7:00pm, 55 min. (This is your weekly rehearsal. Be sure to also select your corresponding Technique Class!)  
$189
OTHER CLASSES
Kickline
$0
Strength & Stretch
$0
Voice Workshop — Winter 
$0
Voice Workshop — Spring 
$0
Adult Tap 
Mon 8:00pm, 55 min. (12 Class Series = $165 >> classes must be completed within registered Session) ($0)   Mon 8:00pm, 55 min. (6 Class Series = $90 >> classes must be completed within registered Session) ($90)   Mon 8:00pm, 55 min. (Drop-In = $20 per Single Class) ($20)  
$165
Adult Ballet 
Wed 8:30pm, 55 min. (12 Class Series = $165 >> classes must be completed within registered Session) ($165)   Wed 8:30pm, 55 min. (6 Class Series = $90 >> classes must be completed within registered Session) ($90)   Wed 8:30pm, 55 min. (Drop-In = $20 per Single Class) ($20)  
$165
Pound 
Thu 6:30pm, 55 min. (12 Class Series = $165 >> classes must be completed within registered Session) ($0)   Thu 6:30pm, 55 min. (6 Class Series = $90 >> classes must be completed within registered Session) ($90)   Thu 6:30pm, 55 min. (Drop-In = $20 per Single Class [Confirmed Reservation Required]) ($20)  
$165
Zumba 
Thu 7:30pm, 55 min. (12 Class Series = $165 >> classes must be completed within registered Session) ($0)   Thu 7:30pm, 55 min. (6 Class Series = $90 >> classes must be completed within registered Session) ($90)   Thu 7:30pm, 55 min. (Drop-In = $20 per Single Class) ($20)  
$165
Baby on Board 
Tue 10:00am, 55 min. (Baby Wearing Workout! 12 Class Series = $165 >> classes must be completed w/in registered Session) ($165)   Tue 10:00am, 55 min. (Baby Wearing Workout! 6 Class Series = $90 >> classes must be completed w/in registered Session) ($90)   Tue 10:00am, 55 min. (Baby Wearing Workout! Drop-In = $20 per Single Class) ($20)   Thu 10:00am, 55 min. (Baby Wearing Workout! 12 Class Series = $165 >> classes must be completed w/in registered Session) ($0)   Thu 10:00am, 55 min. (Baby Wearing Workout! 6 Class Series = $90 >> classes must be completed w/in registered Session) ($90)   Thu 10:00am, 55 min. (Baby Wearing Workout! Drop-In = $20 per Single Class) ($20)  
$165
Wee Workout 
Mon 3:00pm, 55 min. (Workout w/ your toddler! 12 Class Series = $165 >> classes must be completed w/in registered Session) ($0)   Mon 3:00pm, 55 min. (Workout w/ your toddler! 6 Class Series = $90 >> classes must be completed w/in registered Session ) ($90)   Mon 3:00pm, 55 min. (Workout w/ your toddler! Drop-In = $20 per Single Class) ($20)  
$165
DREAM TEAMERS
  1. Check your team below.
  2. Select Acro time in segment above (or 3rd ballet if substituting).
  3. Select above any additional OPTIONAL class(es) and enter the number of classes chosen on the "Optionals" line below.

TEAM FEES LISTED BELOW ARE MONTHLY INSTALLMENTS COVERING CLASSES, REHEARSALS, COSTUMES, TIGHTS (1 PER COSTUME), PRODUCTION FEE, AND MOST TEAM EXPENSES. MONTHLY FEES FOR OPTIONALS INCLUDE LESSONS ONLY (EXPECT COSTUME/ENTRY FEE INVOICE IN OCTOBER).

To participate in Dream Team activities, you must agree to the Dream Team Requirements, listed here. By checking this box, I state that I have read and agree to the Dream Team Requirements.

Need to leave a short note? If you need to confirm that you are substituting a second Ballet for Acro, or if you have any other message you need to have us see regarding your registration, please enter a note in the box below.

New to the Team? Please let us know the extent of your training (enter a note in the box below) and call studio to determine appropriate placement.

Pearl Team 1   $166
Pearl Team 2   $264
Pearl Plus (indicate desired time slot in Acro section above) $87
Opal Team 1 $394
Opal Team 2 $418
Topaz Team $492
Sapphire Team $0
Emerald Team $492
Garnet Team $492
Add Pointe [Mon 8:30pm, 25 min. & Wed 8:30pm, 25 min. & Sat 11:30am, 85 min. (POINTE and Pre-Pointe (11-TEEN))] (no costume deposit included in Pointe fee) $90
If Chrome Acro, add: $29
If Open Acro, add: $0
Optionals: I have added classes (add $30 per class)
TOTAL DUE
 

TOTAL PAYMENT DUE
I am already registered for this season

  1. Registration Fee: Your total will automatically include your dancer's registration fee ($35 per dancer, max $70 per family). We will adjust your registration fee manually if you have met your family max.
  2. Production Fee: IF you are registering for a performance class, your Enrichment session total will automatically include 1/3 of your Production Fee, OR 1/10 if a CoDa or TEAM dancer.
PAYMENT INFO
Please autocharge my session/installment fees on due dates throughout the season.
Please charge registration fee & first session/installment fee ONLY — I will pay directly or charge by phone the remaining payments.

We encourage everyone to use our new ACH option! WHY ACH?

  • It’s convenient (saving you time and postage)
  • Your payment is always on time (even if you’re out of town), eliminating potential late charges
  • SAVES YOU $$!! Register/Authorize Recurring ACH prior to August 15, 2016, stay enrolled through December 1, 2016, and we’ll waive your Registration Fee! That’s a $35 savings to YOU!
  • Authorizing your initial Session Payment, and scheduling recurring payments if you wish, is a breeze!

Here’s How ACH Works:

One-Time Authorization: You authorize your initial Session &/or Installment Payment be withdrawn from your checking or savings account. You will be charged only the amount indicated on our Tuition Table. A receipt for your payment will be emailed to you and the charge will appear on your bank statement as an ”ACH Debit.“ You agree that no prior-notification will be provided unless the date or amount changes, in which case you will receive notice from us prior to the payment being collected.

Recurring Authorization: Should you choose the Recurring Payment option, you will be charged each of the remaining season’s Session &/or Installment Payments using same procedure as above.

Payment Type
Card Number
Name on Card
Expiration Date /
ACH Basic Information

I, authorize A Dancer’s Dream, Inc. to charge my bank account indicated below and as follows:

One-Time Authorization in payment of my dancer’s single Session and/or Installment Fee.

Recurring Authorization on each of the posted session and/or installment due dates indicated below:

Enrichment Session due dates: 8/15/16, 11/7/16, 2/6/17.

Team/CoDa installment due dates: beginning 8/15/16 and on the 15th of each month through 5/15/17.

Further, I understand that I may authorize additional fees (costume, reps, summer, etc) be charged per my my specific written, e-mail, or text request. I further understand and authorize any and all outstanding fees due on my dancer’s account over 15 days past the due date be charged via this ACH process.

Billing address:
City:     State:     Zip:
Phone:
Email:
Bank Information
Account Type: Checking    Savings
Name on Account:
Bank Name:
Account No.:
Bank Routing No.:
Bank City/State:

I understand that this authorization will remain in effect until I cancel it in writing, and I agree to notify A Dancer’s Dream, Inc. in writing of any changes in my account information or termination of this authorization at least 15 days prior to the next billing date. If the above noted periodic payment dates fall on a weekend or holiday, I understand that the payment may be executed on the next business day. I understand that because this is an electronic transaction, these funds may be withdrawn from my account as soon as the above noted periodic transaction dates. In the case of an ACH Transaction being rejected for Non Sufficient Funds (NSF) I understand that A Dancer’s Dream, Inc. may at its discretion attempt to process the charge again within 30 days, and agree to an additional $35.00 charge for each attempt returned NSF which will be initiated as a separate transaction from the authorized recurring payment. I acknowledge that the origination of ACH transactions to my account must comply with the provisions of U.S. law. I agree not to dispute this recurring billing with my bank so long as the transactions correspond to the terms indicated in this authorization form.

I agree to the terms above.

STUDENT WITHDRAWAL POLICY

If you have withdrawn within 4 weeks from the beginning of your first session with us (week #2 for Adult Programs), you qualify for a partial refund (= your payment less registration fees, costume deposit, and lesson fees for all classes held prior to your withdrawal date and including unattended classes). A WITHDRAWAL CONFIRMATION FORM must be completed and returned within 14 days of your withdrawal.

Please note: refunds can take up to 30 days to process.

Overdue balances remaining on account over 15 days will automatically be charged to your VISA/MC. If you are unable to provide an active card number, a flat fee of $25 per month will be applied to your account until all new and outstanding debt is satisfied in full.
DISCLAIMER OF LIABILITY

I, on behalf of the parties hereby registered, authorize A Dancer's Dream, Inc. & TAGteach International, LLC the use of the registered party’s image for educational and promotional purposes.  Further, A Dancer’s Dream, Inc., TAGteach International, LLC, their associates & assigns are not liable for personal injuries, loss of or damage to personal property.  Since dance is a physical activity, injuries may occur.  Each student may decline to participate in any activity which may be harmful & is responsible to inform the instructor, in writing, of any physical limitations which may prevent full participation in class or any associated event.

By checking this box, I release all liability and compensation as stated above.

ACCEPTANCE OF POLICIES

By checking this box, I state that I have read and accept the Accounting Fees and Policies, Dress Code, and Keeping You Up-to-Date information. Click the links to read these pages if you have not already done so.

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