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Referral Information
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Student #1
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Required Policies and Agreements
As the legal parent or guardian, I release and hold harmless TANYA'S DANCE CO., its owners and operators from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participant and/or the undersigned, while in or upon the premises or any premises under the control and supervision of TANYA'S DANCE CO., its owners and operators or in route to or from any of said premises.

The undersigned gives permission to TANYA'S DANCE CO., its owners and operators to seek medical treatment for the participant in the event they are not able to reach a parent or guardian. I hereby declare any physical/mental problems, restictions, or condition and/or declare the paricipant to be in good physical and mental health. I request that our doctor/physician as listed above be called and that my child be transported to the nearest hospital if deemed prudent by the staff. (Please include medical information in boxes above.)

I hereby assume all financial responsibility for the above student (s) enrolled at TANYA'S DANCE CO..

I further understand that I will be charged for all classes until I have notified the studio in writing 30 days in advance of my withdrawal.

I understand that automatic payment information is required to enroll in TANYA'S DANCE CO. I authorize TANYA'S DANCE CO. to automatically charge my account via Automatic Bank Account Debit or Automatic Credit Card Charge for the following fees while enrolled at TANYA'S DANCE CO.

-$30.00 non-refundable registration fee upon submittal of this form and TDC administration review. No registration fee for summer camps/classes.

-Monthly tuition will be charged upon enrollment and on the 1st of each month in which enrolled classes are held.

-Summer camps/classes will be charged a non-refundable deposit of 50% at the time of enrollment, with the remaining balance due the first day of camp/class. Seven days notice is required for all cancellations of a summer camp/class. The non-refundable deposit may be used toward another class at Tanya's Dance Company.

-Dance Recital Costume Fee of $25.00/month starting in October through January with the remaining balance due in February for each class scheduled to perform in the annual dance recital. Parents must notify the office if their child does not wish to participate in recital.

-(For Competition Classes Only) All competition fees charged 30 days prior to competition.

-Recital fee of $30.00 per student due on June 1st for those performing in the annual recital.

-If a payment is rejected due to insufficient funds, I hereby authorize TANYA'S DANCE CO. to withdraw payment for the original amount plus a $10.00 NSF fee. If account becomes past due, a 5% interest charge will be assessed on the balance until balance is paid in full.

I understand that in order to compete and/or perform, I must be present at each class 85% of the time.

I certify that I have read the studio policy and fully understand its content and hereby submit this application. I have read and fully understand all the policies and class procedures of TANYA'S DANCE CO. I agree to abide by, and comply with, the rules, regulations, requirements, and stipulations of Tanya Kinnaman and the Dance Company. I realize that failure to comply with any of these policies will result in immediate action (which could lead to dismissal) by the school director. I am willing to live up to the Code of the Company. If I choose to withdrawl from classes, I understand I must give 30 days notice and will not be refunded.

I Agree to All of the Above
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