Wellspring Dance Academy is excited to offer our rotating Adult Dance classes for Summer 2018. Please check the complete schedule of summer classes on our website at (subject to change). Important Notes: Payment must be received before you can participate in class. Classes will be canceled if less than three (3) people are registered for a given class. A refund will be processed if class is canceled due to low enrollment.
Start Date/Time: End Date/Time:
Fee per Student: Room:
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Address: *
City: * State: * Zip: *
Emergency Contact Info
(Not Contact #1 or #2)
Students entered below will be added to your family's account
What lead you to register for this summer class/pass?
Have you participated in classes at Wellspring Dance Academy previously?*
If so, how recently?
Did you know that Wellspring Dance Academy offers Adult classes year round? *
What other types of classes would you like to see the Wellspring Dance Academy offer?
Additional Information:
Registration and Payment Policies Agreement:
- Wellspring Dance Academy reserves the right to cancel any class with insufficient registration and offers a refund for any cancelled classes that have not occurred.
- Payments are due prior to the start of class or student will not be permitted to participate.
- Payments may be made through the parent portal, at the office, or by mail by Visa, MasterCard, Cash, or Check.
- I understand that my enrollment is not complete until Wellspring has reviewed my registration and received my payment.

I've read the above and agree.
Class Poilcies Agreement:
-No dangling jewelry (necklaces, bracelets, long earrings) may be worn during class.
-No chewing gum, candy, food, or beverage (other than water) is allowed in the Wellspring Theater.
-Students must attend class and perform in concerts barefoot. Socks may be worn only at the beginning of class during warm-up. Footed tights are dangerous to dance in and may not be worn at any time.
-Students who exhibit repeated negative or disrespectful behavior may be asked to no longer participate in Wellspring classes.
-Student enrollment in class will not be guaranteed until the class fee is received.
-Please contact Wellspring at 269-342-4354 with any questions or concerns you have about classes.
-Class cancellations will be emailed to you and posted on our Facebook page.

I've read the above and agree.
Liability Release:
I confirm my understanding that participation in dance classes carries with it a reasonable assumption of risk. Wellspring/Cori Terry & Dancers and its instructors are not liable for personal injuries.
I've read the above and agree.
Photo/Video Release:
I grant permission to Wellspring/Cori Terry & Dancers to use performance and in-class photos and video images for promotional purposes. This helps Wellspring create meaningful, authentic promotional pieces.
I've read the above and agree.
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