Enrollment Form

Please fill out the following form.

Dancer First name

Dancer Last name

Date of birth

Select Classes

Tutu Cute THURSDAY Ages 3-5

Minis Jazz/Musical Theatre 1 Ages 3-7

Ballet 1 Ages 5-6

Ballet 2 Ages 7-9

Ballet 3/4 Ages 9-12

Ballet 5,6,7,8 THURSDAY Ages 9+

Ballet 5,6,7,8 SATURDAY Ages 9+

Monday Morning Ballet Ages 3-4

Monday Morning Ballet Ages 5-6

Monday Morning Ballet Ages 7-11

Monday Morning Ballet Ages 12+

Wednesday Morning Ballet Ages 3-4

Wednesday Morning Ballet Ages 5-6

Wednesday Morning Ballet Ages 7-11

Wednesday Morning Ballet Ages 12+

Beginning Pointe (By Invitation Only)

Pointe (By Invitation Only)

Tap 1 Ages 3-8

Tap 2/3 Ages 9+

Jazz 2/3 Ages 9+

Musical Theatre 2 Ages 8+

Contemporary 2/3 Ages 9+

Boys Only Class SATURDAY Ages 3-5

Hip-Hop 2 Ages 9+

Thursday Morning Pilates (Ages 13+)

6 Weeks Ballet Course (Ages 13+)

6 Weeks Belly Dance Course (Ages 13+)

First Parent First Name

Parent Last Name

Relationship To Dancer

Phone

First Parent Email

Second Parent First Name

Second Parent Last Name

Relationship To Dancer

Phone

Second Parent Email

Please list below an emergency contact other than the dancer's parents who has permission to pick up your dancer if something happens or we cannot get ahold of primary contacts.

Name of Emergency Contact Other Than Parent 1 or 2

Phone

Relationship To Dancer

Liability Waiver: I hereby certify that I am in physical condition that will allow me to participate in dance and or fitness classes at Julia’s Academy of Dance. I release Julia’s academy of dance and its agents from any claims, demands and causes of actions as a result of my voluntary participation in these classes/performances. I fully understand that I may injure myself in these classes, and I release Julia’s Academy of Dance of all responsibility from damages or loss to personal property (including vehicles) brought to Julia’s Academy of Dance. I will be responsible for any damage or losses that I cause to the property of Julia’s Academy of Dance and its students and teachers. I hereby certify that Julia’s Academy of Dance has permission to take photos/videos of me during auditions/classes/rehearsals and performances to be used with discretion for advertising and marketing.

I have read and agree to the liability statement above

Acknowledgement of Payment: I agree to pay a one-time registration fee of $50 for new students a yearly enrollment fee of $50 for all returning students each consecutive year in August or before the semester begins. I understand that my tuition payment will not change for the duration of this semester, but rates may change thereafter. I understand there is a $20 fee for any returned checks. I agree to pay a $25 late fee for any balances that remain unpaid within 10 days of the due date or for any payment that declines. I acknowledge that I will not be able to attend classes at Julia’s Academy if my past due balance (including late fees) exceeds double (2x) my monthly tuition.*I am also in agreement that I or my child am committing to the above class(es) for a semester and that I will not drop said class(es) mid-semester. Should I need to withdraw from a class, I am acknowledging that I will continue to pay for (or be charged accordingly) for the duration of that semester in accordance with the amounts stated in this contract. We will continue billing for the next semester unless you cancel your classes. A semester is from August 1st-December 31st or January 1st-May 31st (Summer classes are independent but will be automatically charged unless you place your account on hold before June 1st.)

I have read and agree to the billing policy above.

Private Lessons: I agree that if I (or my child) opt to receive private lessons that I will have a card on file with Julia’s that can be used as either my main form of payment or as a backup form of payment. I agree to pay for my private lesson either in advance or on the day of the lesson by cash or check. If I do not remit payment by the conclusion of said lesson, my card will be charged for the standard private lesson fee charged by my specific instructor. By committing to a private lesson appointment time, I am committing to show up at that day/time, and that if I do not show up, I am agreeing to remit payment in my (or my child’s) absence. If I need to reschedule for any reason, I accept sole responsibility for communicating with the instructor to make alternate arrangements at least 24 hours in advance of the original scheduled lesson time. If I fail to reschedule at least 24 hours in advance (except in cases of extreme emergency) I agree to remit payment as a late fee.

I have read and agree to the private lesson statement above.

Cancellation Policy: If you need to cancel your dancers’ classes at the end of a semester you must either fill out a cancellation form at the front desk or email the studio at jdanceacademy@yahoo.com before the end of the semester. If your dancer will be taking a break during the summer, you will need to let the front desk know by May 1st so we can pause your payments. If you need to cancel mid semester, we require 30 days’ notice in writing, or you will be automatically charged for the next month.

I have read and agree to the cancellation policy above.

I hereby acknowledge that all information that I have provided is accurate to the best of my knowledge. If any of the above information changes will let the front desk know by emailing jdanceacademy@yahoo.com. I certify that I have read all of the above information and policies that are in place for Julia's Academy of Dance.

Signature