Moving in the Spirit Online Registration

Registration

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Welcome to Moving in the Spirit's online registration!

If you are a returning family, you may enroll via the Login link above. Instructions for payment options and accessing your tuition account online will be emailed to you upon completion of this form.

As a nonprofit, we collect information on ethnicity and household income for grant reporting purposes. This information is submitted anonymously. Your name and address remain confidential.

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Referral Information

How did you hear about us?

Referral Name

Family Information

Account Last Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Home or Primary Phone*

Additional Info

Emergency Contact Info*

Health Insurance Carrier & Policy Number*

Qualify for free/reduced lunch*

Number of people in household*

Annual Household Income*

Public Assistance collected*

Applying for financial aid?

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone *

Work #

Cell # Receive Text Message Notifications

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name

Last Name

Type*

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

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*

Does your child have any physical challenges or special needs? If yes, explain.*

Is child currently seeing a counselor/therapist? If yes, explain and provide contact information.*

List any food allergies your child has.*

Is your child currently on any type of medication? If yes, please list. If no, please write No.*

Primary Doctor Name and Phone*

Adults authorized to pick up my child from class*

Resident of City of Atlanta?*

Who does student live with?*

Student's ethnic background*

Does your child have an IEP?*

Family County of Residence*

Click "Search" below. Select an appropriate School Year class based on your child's age & gender.

Students registering for Apprentice Corporation and GLOW in Motion must participate and register for auditions. Men in Motion is invite only. Students registering for Stepping Stones classes (Mini Steps, Baby Steps, Girls in Motion, Collective Motion, Boys in Motion or a Movement Lab) should select only ONE day to attend.

Fees listed represent monthly tuition.

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*

Does your child have any physical challenges or special needs? If yes, explain.*

Is child currently seeing a counselor/therapist? If yes, explain and provide contact information.*

List any food allergies your child has.*

Is your child currently on any type of medication? If yes, please list. If no, please write No.*

Primary Doctor Name and Phone*

Adults authorized to pick up my child from class*

Resident of City of Atlanta?*

Who does student live with?*

Student's ethnic background*

Does your child have an IEP?*

Family County of Residence*

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*

Does your child have any physical challenges or special needs? If yes, explain.*

Is child currently seeing a counselor/therapist? If yes, explain and provide contact information.*

List any food allergies your child has.*

Is your child currently on any type of medication? If yes, please list. If no, please write No.*

Primary Doctor Name and Phone*

Adults authorized to pick up my child from class*

Resident of City of Atlanta?*

Who does student live with?*

Student's ethnic background*

Does your child have an IEP?*

Family County of Residence*

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*

Does your child have any physical challenges or special needs? If yes, explain.*

Is child currently seeing a counselor/therapist? If yes, explain and provide contact information.*

List any food allergies your child has.*

Is your child currently on any type of medication? If yes, please list. If no, please write No.*

Primary Doctor Name and Phone*

Adults authorized to pick up my child from class*

Resident of City of Atlanta?*

Who does student live with?*

Student's ethnic background*

Does your child have an IEP?*

Family County of Residence*

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*

Does your child have any physical challenges or special needs? If yes, explain.*

Is child currently seeing a counselor/therapist? If yes, explain and provide contact information.*

List any food allergies your child has.*

Is your child currently on any type of medication? If yes, please list. If no, please write No.*

Primary Doctor Name and Phone*

Adults authorized to pick up my child from class*

Resident of City of Atlanta?*

Who does student live with?*

Student's ethnic background*

Does your child have an IEP?*

Family County of Residence*

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

(Show-Hide Details)

Parent Contract of Commitment

Moving in the Spirit is a creative youth development program that uses the discipline of dance to instill within Atlanta's youth the skills they need to thrive.

I give my child permission to participate in Moving in the Spirit programs. I commit to make every effort to get my dancer to classes and related activities on time and prepared, as well as pick him or her up on time.

I acknowledge that Moving in the Spirit fosters the values of responsibility, respect and dedication, and I will partner with the organization to uphold these values. I realize that if my child chooses to act in a manner that is inappropriate and disruptive, he/she will be asked to leave the class and will not be able to re-enter the class without a successful conference with my child, the Moving in the Spirit teacher and myself.

Moving in the Spirit strives is to provide a safe and supportive environment that is conducive to learning and developing positive coping skills. Therefore, aggressive behavior towards another person (e.g., pushing, hitting, kicking, spitting or fighting) that is meant to cause a negative response or start a physical altercation will not be tolerated. By exhibiting aggressive behavior, the participant is making a decision to no longer participate in Moving in the Spirit programming.

POLICIES FOR SCHOOL YEAR PARTICIPANTS:

EARLY DROP-OFF/LATE PICK-UP POLICY: I acknowledge that each registered student will receive a schedule of classes. Parents may drop their child off no earlier than 15 minutes prior to the start of their child's scheduled class, rehearsal or performance. Parents are expected to pick-up their child no later than 15 minutes after the scheduled class, rehearsal or performance ends.

The sign-in sheet indicates the dancer's name and the time the parent arrived/departed. The parent must sign in and out on the sign-in sheet when their dancer is dropped off/picked up for class. The Administrative Assistant or on-duty staff informs administration when dancers are dropped off too early or picked up late.

HOLIDAY STORE AND PERFORMANCES: I understand that all students in Moving in the Spirit programs will participate in the annual Holiday Store in December and the Year-end performance in May. The exceptions are the Baby Steps and Movement Lab students who have a separate year-end demonstration at a venue to be determined.

All other students will have their year-end performance at the Rialto Center for the Arts at Georgia State. ALL students participating in year-end performances are required to attend additional mandatory rehearsals outside of their normal class schedules.

EVALUATION: I understand that Moving in the Spirit utilizes various assessment tools and surveys as part of its program evaluation process. The assessments include, but are not limited to: the Piers-Harris-2 Children's Self-Concept Scale and the Developmental Assets Profile. My child's information is confidential and will remain anonymous. I give consent for my child to participate in the program evaluation process.

EXCESSIVE TARDINESS AND ABSENTISM: I understand that if my child is going to miss three or more consecutive classes, I must notify Moving in the Spirit's Administrative Assistant of the intended absences. Failure to do so will results in my child being dropped from the class.

I've read the above and agree.

Tuition & Need-Based Financial Aid

I've read the above and agree.

Parent Consent and Release Agreement

***** PLEASE READ THIS AGREEMENT CAREFULLY.
IT IS A LEGAL DOCUMENT THAT AFFECTS YOUR RIGHTS ******

1. Student's Participation. I hereby consent to my child participating as a student in the Moving in the Spirit program and its related activities.
2. Hold Harmless. In consideration of Student participating in the Moving in the Spirit program, I hereby agree to release, indemnify and hold harmless, to the fullest extent permissible under the law, Moving in the Spirit, Inc. and its members, officers, directors, employees, contractors, volunteers, representatives, successors and assigns (the "Indemnified Parties") from and against any and all actions, claims or losses, whether known or unknown, anticipated or unanticipated ("Claims"), that might arise out of or in connection with the services provided or performed by any of such parties in connection with the Moving in the Spirit program, whether such Claims are based on negligence, strict liability, breach of warranty, contract or otherwise. In addition, I fully, completely, and unconditionally waive and release each of the Indemnified Parties from all rights, liabilities, duties, claims, charges, demands, actions, damages, costs, attorney fees, or expenses of any kind that I may have now or in the future against any of them relating to Student's participation as a student in the Moving in the Spirit program. The foregoing indemnifications, waivers and releases shall not apply to any Claims arising out of the sole negligence of any of the Indemnified Parties.
3. Following Program Rules. Student shall abide by the instructions, policies and regulations of Moving in the Spirit, Inc., as the same may be provided or related to Student or to me from time to time. I understand that any violation of such instructions, policies and regulations will result in suspension and/or termination of Student's participation in the program.
4. Photo / Video Release. I hereby grant to Moving in the Spirit, Inc. the right and permission, in respect of any photographs, video and/or audio recording which any of the Indemnified Parties take or have taken of Student, or in which Student may be included with others, to copyright the same in the name of Moving in the Spirit, Inc. or otherwise; to use, reuse, publish and re-publish the same in whole or in part, in conjunction with any printed matter in any and all media now or hereafter known, and for any purpose whatsoever, for illustration, promotion, art, advertising and trade, or any other purpose; and to use Student's name and any statement made by Student, in connection therewith if Moving in the Spirit, Inc. so chooses.
5. Privacy and Confidentiality. I understand that Student will be expected to keep any private and confidential information pertaining to Moving in the Spirit, Inc. and its other students, volunteers and staff private and confidential. I understand that Student's failure or inability to abide by such confidentiality requirements will result in suspension and/or termination of Student's participation in the program
6. Transportation of Student. I acknowledge that Student will be transported by volunteers and other representatives of Moving in the Spirit, Inc. while participating in the Moving in the Spirit program. I consent to such transportation and agree that such transportation is voluntary and at Student's and my own risk.
7. Emergency Medical Care. In the event of a medical emergency, I authorize Moving in the Spirit, Inc., and its adult agents, employees and representatives into whose care Student has been entrusted to consent on my behalf to any medical treatment and hospital care to be rendered to Student in order to ensure Student's safety and well-being.
8. Contact with Student / Access to Information. I hereby give permission for any staff member or representative of Moving in the Spirit, Inc. to visit Student at her school and elsewhere outside my presence, for the purpose of furthering the goals of the Moving in the Spirit program. I hereby authorize Moving in the Spirit, Inc. to obtain any needed information regarding Student, including academic, behavioral and medical records, from school and medical personnel and to have a conversation regarding the same with teachers, counselors, other school administrative staff, doctors, nurses and medical facility administrative staff.
9. Severability. In the event that any portion of this agreement is held to be invalid or unenforceable, the validity or enforceability of the remainder of this agreement shall be unaffected and shall remain valid and enforceable to the full extent permissible under law.
10. Governing Law. This agreement and any disputes arising under or in connection with it or the services provided by me or any of the Indemnified Parties shall be governed by the laws of the State of Georgia. I hereby submit to the exclusive jurisdiction of the state and federal courts of the State of Georgia for the settlement of any and all such disputes.
I certify that I am the parent or legal guardian of Student, or that I otherwise have the legal authority to represent Student and act on Student's behalf. I have read and understood this agreement. I hereby consent to and ratify this agreement and agree, on behalf of myself, Student, and each of our respective personal representatives, heirs and next of kin, to be bound by its terms.

I've read the above and agree.

Program Calendar 2019-2020

I've read the above and agree.

I Agree to All of the Above

Enter your Full Name*

Questions or Concerns

Comments

Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies and Agreements (Show-Hide Details)

I Agree to All of the Above

Questions or Concerns

Required Policies and Agreements

(Show-Hide Details)