New Dance Student Registration Form
Name_____________________ ______________________________ __________ First Last M.I
Address__________________________________ _________
Street apt.#
__________________________________ _________ ____________
City State Zip Code
Phone #_____________________ _____________________ _____________________
Work Home Cell
Email_____________________________ Birthday________ _________ _________
Month Day Year
Class(es) Registering For____________________________________________________________________
Check the box if you are interested in joining us for performance opportunities. [ ] Yes, I am interested
Payment form must be filled out completely before registation process is complete.
- Discounts are available for multiple classes, for semester payments, and for siblings. Call (404) 943-1063 for more info., or check price sheets at front desk.
How Did You Hear Of Muse for Life?________________________________________________________
Contract of Permission and Policies:
I _______________________(print parent or guardian name),___________________(relationship) of the student, will allow my child to participate in classes at Muse for Life. I will allow my child's photograph to be used in promotional materials. I understand that these classes will require physical activity by my child and the risks that may be associated with such activity. I understand that the school year length program will include 10 months of instruction, August-May. I agree to submit a written notice 30 days in advance to withdrawing my child from the program. No refunds are granted for classes not attended by student.Students absences may be made up in an alternative class within 30 days of the missed class. Classes cancelled by the instructor will be rescheduled within 30 days of the cancelled class, unless class reschedule is not possible, in which case, a refund may be given for cancelled class(es). No liability is assumed by Muse for Life, any Muse for Life instructors, or staff for any accidents or injuries. The person herein signing this agreement on behalf of said student, assumes full responsibility. I understand that the charge for registration is $20, and that this $20 registration fee is non-refundable under any circumstances. I also understand that Muse for Life requires a 30 day notice from the first of the month in order to discontinue lessons, and, therefore, Muse for Life will not be accountable for any discontinuation of payment collection unless this notice has been given. I understand that the time which I have registered for is the only time which Muse for Life is accountable for services during, but I also understand that circumstantial adjustments to this time can be made at the front desk, and that Muse for Life will honor such adjustments as long as they are communicated and rescheduled at least 24 hours prior to the original scheduled time. I also understand that under no circumstances is Muse for Life responsible for giving services for lesson times which were missed without notice or cancelled late. All cancellations must occur at least 24 hours prior to the scheduled lesson time in order to be honored for make-up. Finally, I understand that all payments are due for collection on the first day of each month, and that the monthly payment includes one lesson charge for each time the scheduled lesson day occurs within that month.
Parent or Guardian signature:_________________________________________________ Date:__________________