Registration Form — Dancefx

Dancefx ATHENS Registration Form

Dancer's Name

First Name

Last Name

Gender

Dancer's Birthdate

YYYY

Parent's Name (if under 18)

Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone Number

(###)

###

####

How did you hear about Dancefx?

Payment

Any option other than autopayment with a card on file requires an additional $5 monthly processing fee. Any tuition payments received after the 5th of the month for youth dancers or the 19th of the month for adult dancers automatically incurs an additional $15 late fee.

Credit Card Information

Please indicate your credit card number, expiration date, security code, and billing zip code if you would like to use a card as your method of payment.

Would you like us to save this card information on file to be used in the future? If you select "no" the information will be disposed immediately following the initial charge. Card information kept on file is encrypted as soon as it is saved on the dancer's account.

Yes please

No thank you

Which session are you registering for?

Which class(es) are you interested in for enrollment? Please see our class schedule pages for monthly tuition rates.

Please write your full name and today's date to indicate you have read and agree to the following policy: I understand I am entering into a tuition contract and I am liable to pay $25 for an annual registration fee (Not applicable to Athens Academy Winter Session students). I understand if I have not selected autopayments, a $5 processing fee will be added to my monthly tuition. I agree to pay tuition on the 1st (for youth dancers) or 15th (for adult dancers) of each month through the end of the session. SUMMER TUITION RUNS ON THE 15TH OF EVERY MONTH FOR ALL DANCERS (youth and adult). I understand tuition is NON-REFUNDABLE.

Please write your full name and today's date to indicate you have read and agree to the following policy: I understand by registering for classes at Dancefx Athens, I have entered into a contract from today's date through the remainder of the session. Tuition payments received later than the end of the business day on the 5th of each month (for youth) or the 19th of the month (for adults) or the 19th for ALL SUMMER contracts (youth and adult) will automatically be charged a $15 late fee on their account. For accounts that are more than one month overdue, an additional charge of 15% of the remaining balance will be accrued. The account balance must be paid before the dancer can resume classes.

Please write your full name and today's date to indicate you have read and agree to the following policy: If I choose to discontinue classes before the end of the session, I understand that I must notify Dancefx in writing to Allison@dancefx.org or Cheryl@dancefx.org 5 business days prior to the tuition due date. A $10 withdrawal fee is required to be paid and will be deducted from the card on file. I understand that I am responsible for paying monthly tuition if the withdrawal process was not completed according to this policy.

Please write your full name and today's date to indicate you have read and agree to the following policy: I understand that if I or my dancer is unable to attend their regularly scheduled class, Dancefx will allow the dancer to make up this class with another class similar in age/level. Make up classes must be used within the semester they were missed. Make up classes cannot be saved and used during another semester or session. I understand no refunds will be given for any unused make up classes.

Please read the following liability waiver below and write your full name and today's date below to indicate that you have read and agree to the following.

The undersigned hereby acknowledges that participation in dance programs and outreach activities involves an inherent risk of physical injury and hereby assumes all such risks. Dancefx assumes no responsibility under any circumstances or at any time for personal property of the undersigned. The undersigned hereby agrees that for the sole consideration of Dancefx allowing the undersigned to participate and making available to the undersigned for his/her use while participating in such programs, activities or personnel, the undersigned participant does hereby waive liability, release and forever discharge Dancefx, its board members, instructors and employees from any and all demands, rights and causes of action of whatever kind or nature, arising out of all known and unknown, foreseen and unforeseen bodily and personal injuries, damage to or loss of property, and the consequences thereof, including death, resulting from my participation in or in anyway connected with such dance programs or outreach activities located on the premises or offsite. I acknowledge that it is my responsibility to seek the advice of a medical professional if I have questions about my (my child’s) physical ability to participate in any dance activity. I further covenant and agree that for the sole consideration stated above I will not sue Dancefx, its members, instructors, or employees for any claim for damages arising or growing out of my (my child’s) participation in the dance programs or outreach activities. This Release, Waiver of Liability and Covenant Not to Sue shall remain in effect for as long as I (my child) am (is) a participant in programming at Dancefx. I certify that I (my child) am (is) suffering under no legal disabilities and that I have read the above carefully before signing.

Please use the space below for any notes or questions.

Thank you for registering yourself or your dancer at Dancefx! Please note that by submitting your electronic signature above, you are providing an electronic mark that is held to the same standard as a legally binding equivalent of a handwritten signature provided by you. Your registration will not be completed until payment has been received, and we must have a signed liability waiver on file prior to the dancer's first class. Please contact Cheryl@dancefx.org, call our front desk at 706-355-3078, or visit the studio during business hours to submit information for payment if you have not done so within this form.

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