Registration

Parent/Guardian:
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Address:
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- Street Address
- Address Line 2
- City
- State / Province / Region
- Postal / Zip Code
- Country
Cell #:
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Home #:
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Work #:
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Email Address
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Student's Name:
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Student's Date of Birth
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Does your child have any disabilities I should be aware of?
Pre-1 Age 3: Ballet/Tap Combo Check All That Apply

Tue 10:30 - 11:30 Show 1
Wed 4:00 - 5:00 Show 2
Thu 5:00 - 6:00 Show 1
Sat 9:30 - 10:30 Show 3
Pre-2 Age 4: Ballet/Tap Combo Check All That Apply
Tue 10:30 - 11:30 Show 1
Wed 4:00 - 5:00 Show 2
Thu 5:00 - 6:00 Show 1
Sat 9:30 - 10:30 Show 3
Kinder Age 5: Ballet/Tap Combo Check All That Apply
Wed 3:30 - 4:30 Show 2
Fri 3:30 - 4:30 Show 1
Sat 9:30 - 10:30 Show 3
L1-1st Grade: Ballet/Tap Combo Check All That Apply
Wed 3:30 - 4:30 Show 2
*Full* Wed 5:00 - 6:00 Show 2
Fri 3:30 - 4:30 Show 1
Sat 9:30 - 10:30 Show 3
L2 - 2nd Grade: Ballet/Tap Combo Check All That Apply
*Full* Wed 5:00 - 6:00 Show 2
Sat 10:30 - 11:30 Show 3
L3 - 3rd Grade: Ballet/Tap Combo Check All That Apply
Sat 10:30 - 11:30 Show 3
Ages 6-8: Hip Hop/Tumbling Check All That Apply
Fri 4:30 - 5:30 Show 1
Hip Hop: Check All That Apply
Beg./Int.: Wed 6:00 - 7:00 Show 2
Int./Adv.: Tue 3:45 - 4:45 Show 3
Boys: Wed 7:00 - 8:00 Show 3
Tumbling: Check All That Apply
Beg./Int.: Wed 5:30 - 6:30 Show 2
Adv.: Wed 6:30 - 7:30 Show 3
Contemporary: Check All That Apply
Int./Adv. (Open Age): Fri 5:30 - 7:00 Show 1,2
IL1: Check All That Apply
Ballet: Tue 3:30 - 4:30 Show 1
Modern: Tue 4:30 - 5:30 Show 1,2
Jazz: Fri 4:00 - 4:45 Show 1,2
Tap: Fri 4:45 - 5:30 Show 1,2
IL2: Check All That Apply
Modern: Tue 4:30 - 5:30 Show 1,2
Ballet: Tue 5:30 - 6:30 Show 2,3
Jazz: Fri 4:00 - 4:45 Show 1,2
Tap: Fri 4:45 - 5:30 Show 1,2
IL3: Check All That Apply
Ballet: Mon 3:45 - 5:00 Show 1,2,3
Modern/Lyrical: Mon 5:00 - 6:00 Show 1,2
Ballet Tech: Thu 4:30 - 6:00
Jazz: Thu 6:00 - 6:45 Show 1,2
Tap: Thu 6:45 - 7:30 Show 1,2
IL4: Check All That Apply
Ballet/Pointe: Mon 3:45 - 5:00 Show 1,2,3
Modern/Lyrical: Tue 6:30 - 8:00
Ballet Tech:Thu 4:30 - 6:00
Tap: Thu 6:45 - 7:30 Show 1,2
Jazz: Thu 7:30 - 8:30 Show 1,2
IL5: Check All That Apply
Ballet/Pointe: Mon 6:00 - 7:30 Show 1,2,3
Tap: Tue 5:30 - 6:30 Show 1,2
Modern/Lyrical: Tue 6:30 - 8:00 Show 1,2
Ballet Tech: Thu 6:00 - 7:30
Jazz: Thu 7:30 - 8:30 Show 1,2
IL6: ** All Partnering girls must weigh 115 lbs. or less. Check All That Apply
Ballet/Pointe: Mon 6:00 - 7:30 Show 1,2,3
Partnering**: Mon 6:30 - 7:30
Tap: Tue 5:30 - 6:30 Show 1,2
Modern/Lyrical: Tue 6:30 - 8:00 Show 1,2
Ballet Tech: Thu 6:00 - 7:30
Jazz: Thu 7:30 - 8:30 Show 1,2
Pointe Tech: Sat 10:30 - 12:00
IL7: ** All Partnering girls must weigh 115 lbs. or less. Check All That Apply
Ballet/Pointe: Mon 5:00 - 6:30 Show 1,2,3
Partnering**: Mon 6:30 - 7:30
Tap: Tue 5:30 - 6:30 Show 1,2
Modern: Tue 6:30 - 8:00 Show 1,2
Jazz: Tue 8:00 - 9:00 Show 1,2
Lyrical: Wed 7:30 - 9:00 Show 1,2
Ballet Tech Thu 7:30 - 9:00
Pointe Tech Sat 10:30 - 12:00
IL8: ** All Partnering girls must weigh 115 lbs. or less. Check All That Apply
Partnering**: Mon 6:30 - 7:30
Ballet/Pointe: Mon 7:30 - 9:00 Show 1,2,3
Tap: Tue 5:30 - 6:30 Show 1,2
Modern: Tue 6:30 - 8:00 Show 1,2
Jazz: Tue 8:00 - 9:00 Show 1,2
Lyrical: Wed 7:30 - 9:00 Show 1,2
Ballet Tech: Thu 7:30 - 9:00
Pointe Tech: Sat 10:30 - 12:00
$45.00 Registration Fee if applicable.
Photography/Videography Consent:
*

I Do give permission for photography/videography of my child for use in advertising and/or display purposes. I am willing to release said media into public domain and understand that no monetary compensation will be given for the use of said media.
Parental Consent
*

I herin release my child to participate in dance class(es) and will not hold Mann Dance Academy, Inc. liable for any injury they might incur.
Typed Signature:
*

Registration Form

A $45.00 Registration Fee is due once per the calendar year per student. A 7.625% Sales Tax is added to all tuition and items sold at Mann Dance Academy, Inc.

Tuition is due the first of the month. A $15 late fee will be added to all unpaid balances on the 15th of every month.