Studio 320 Dance Online Registration

Registration

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Entering Credit Card information at end of Registration Form will automatically add you to our Studio's ePAY option for the upcoming session and school year. Should you leave the Credit Card section blank, it is your responsibility to pay all registration and tuition fees in the Studio front office. Your enrollment is not finalized until we receive and process your registration payment.

* denotes required fields

Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

Cell #

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Home Phone

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Student Email

T-Shirt Size

School

Grade Level

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Release of Liability

Injuries
Parents, legal guardians of minors, students, and visitors waive the right to any legal action for any injury sustained on Studio 320, LLCs property resulting from normal dance and acrobat activity or any other activity conducted by the students, parents, siblings and other visitors before, during, or after class time.

Consent / Release
I hereby waive and release Studio 320, LLC and its officers, agents, volunteers, and employees from all acts or omissions resulting in any physical injuries, medical treatment, or other damages to myself or any minors of whom I am parent or legal guardian, resulting from participation in Studio 320, LLCs programs. I further waive and release Studio 320, LLC and its officers, agents, volunteers, and employees from any damages sustained by the aforementioned or any guests of the aforementioned as a result of any condition, act, omission, or accident on or at 320 S. Platte Clay Way, Kearney, Missouri, or any other premises upon which any activity related to Studio 320, LLC takes place.

Photo, Video, Audio, & Testimonials release: I hereby give permission to Studio 320, LLC to photograph, video, film and/or audio record my child and/or me and to use any written or verbal testimonials I provide to them. I consent to the use of such materials for all uses including all promotional and marketing materials. This release is granted in perpetuity.

I've read the above and agree.

Form of Payment - ePay

IMPORTANT: PLEASE READ!

Studio 320, LLC offers "ePAY" to conveniently collect fees directly from your credit card account. BY ENTERING YOUR CREDIT CARD information below, YOU HEREBY ELECT TO ALLOW STUDIO 320, LLC TO ELECTRONICALLY COLLECT ALL FEES FOR YOUR ACCOUNT. Student Registration Fees will be charged upon enrolling online for selected classes. This will hold and guarantee your child's place in class for the upcoming school year. Future fees, including but not limited to Quarterly Tuition, Recital Costume Deposits, and Recital Costume Balances will be charged to your indicated ePAY account on the TUITION and COSTUME due dates posted above, on the Studio 320 website, and at the Studio 320 front desk. ePAY charges are non-refundable and you must provide instruction in writing to the front office 7 business days before charge dates in order to discontinue service. Should you leave the ePAY account information blank below, it is your responsibility to pay fees by check, cash or credit/debit card in the Studio front office. YOUR ENROLLMENT IS NOT FINAL until the Registration Fee is received and applied to your Studio account.

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Payment Information

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*