Registration

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U Can Danz! Dance Company ~ Registration Form 2019-2020

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Referral Information
Family Information
Where do you live?
Additional Info
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
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Who is your employer?
Contact #2
How can we contact you?
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Who is your employer?
Student #1
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Additional Info

Please remember if you are registering for Elite Dance Team these classes meet two days per week. You must select both days (Day 1 of 2 and Day 2 of 2)

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Required Policies and Agreements
WAIVER TO KRISTINA HOLTZLEICER and U CAN DANZ! DANCE COMPANY
In consideration of your acceptance of my child as a participant in the U Can Danz! Dance Company ("U Can Danz!") program, I hereby waive all claims against Kristina Holtzleicer, and U Can Danz!, its employees and agents, and release Kristina Holtzleicer, and U Can Danz!, its employees and agents, from all claims for all injuries suffered by my child incidental to, connected with, or arising out of the recreational activities for which my child is enrolled, including injuries suffered as the result of negligence of Kristina Holtzleicer, or U Can Danz!, or its employees or agents, but not including injuries suffered as a result of their willful or intentional misconduct or gross negligence.

I give my approval to my child's participation in all U Can Danz! sponsored activities, performances, practices, rehearsals, and shows.

I understand the program for which I have given my child's permission to enroll, may be hazardous and that injuries may occur in the normal course of participation of instruction and I assume all risks and hazards incidental to my child's participation including transportation to and from the activities. I understand and acknowledge that U Can Danz! has no medical or health insurance covering my child. I also understand that
U Can Danz! reserves the right to refuse service to anyone.

I have also read and understand all the policies for U Can Danz! Dance Company. I understand that if someone does not cooperate with the mentioned information and policies, they could be asked to leave UCD. I also understand that I am responsible for all the fees and services rendered that are involved with my child participating in U Can Danz! Including (but not limited to) items ordered for my child.

The undersigned gives permission to Kristina Holtzleicer, DBA U Can Danz! Dance Company, 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, resrtictions, or condition and/or declare the participant to be in good physical and mental health. In the case of an emergency, my child will be brought the nearest Emergency Room/Medical Facility.

Registration Fee & first month's tuition are non-refundable unless your class was cancelled, or switched to a new time that no longer works with your schedule. Tuition fees are based per month, some months your child may attend four classes, other months, two or three. Tuition is not adjusted for months with fewer classes. UCD has a three-week Holiday Break and a two-week Spring Break. In the case of bad weather, or any other reason out of our control, and classes have to be cancelled, UCD is not required to schedule a make-up day or issue any refunds. UCD usually follows the weather closings of the local school district.

All payments are scheduled for the 1st of each month. If any electronic debits(s) should be returned by my financial institution as Non-Sufficient Funds (NSF), I authorize, Kristina Holtzleicer, DBA U Can Danz! Dance Company, to collect a returned item fee of $25.00 per item by electronic debit from my account on file.

One Costume for each dancers is required. Costume and tights fee will be posted to your account on Sept. 15.
Costumes are $75 for youth, $80 for adult size. Tights are $7 for youth, $9 for adult.
Competition Team Dancers will require additional costumes, and will be contacted separately about those fees.

I have read and understand the "Monthly Breakdown for Auto Pay Payments" that is located on the Chanhassen Information Page of the website.
I understand some months there my be more than tuition added to my payment, and that UCD will give me
a 30-day notice of the additional amount.

If you decide to drop out of UCD, you must give a 30-day written notice. Families are responsible for the next month's tuition. There will be a $25 drop-out fee.

By clicking "I agree", I have read and understand the above policies. I authorize Kristina Holtzleicer, DBA U Can Danz! Dance Company to perform scheduled or periodic electronic funds transfer debits and/or credits from my account in which I have provided during registration for payments due or when applicable, apply electronic funds transfer credits to the same. I understand the dollar amount can vary depending on services performed.

I Agree to All of the Above
Questions or Concerns
Payment Information
eCheck/Bank Draft
(Your name on your bank statement)
(9-digit number)