Registration fee	$10.00
Tuition	$30.00
2nd child	$20.00

Class Registration

To enroll your child with The Dance Connection, please submit the form below, or download our printable registration form (PDF).

Child's Name*
Birth Date*	//
Parents' Names*
Phone*
Alternate Phone
Email*
Address*
City*
State*
Zip*
Name of school or childcare center
Medical or other information we should know

*Required Field

I understand and agree that participation in any moving activity carries a risk accidental injury. In the event that my child should sustain an injury of any nature, I, parent/guardian of the above child assume all responsibility and will not hold The Dance Connection LLC, owners, instructors, or childcare center liable.

Tuition is due by the first lesson of each month. If your child starts class in the middle of the month, tuition is prorated at $7.50 per lesson to the end of the month. ($10.00 registration remains the same.) Once enrolled your child will participate each week until written notice is given (leave note in tuition payment drop, or email us.

Photo/Video Release grant permission for my child to be photographed or videotaped during dance class or recitals which may be used in promotion of The Dance Connection program.

I have read, understand, and enroll my child in The Dance Connection program.

In accordance with the Electronic Signatures in Global and International Commerce Act of 2000, electronic contracts and signatures are as valid as paper contracts in all states, regardless of where the parties live or where the contract is executed. You have the right to request a paper registration form from us. Regardless of whether you make such a request, your electronic signature on this registration form shall remain legally valid and binding.

Parent/Guardian's Signature:
Date: February 7, 2012