Registration

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* PLEASE NOTE * Multi-class discounts and monthly payments are calculated manually. Your card will not be immediately processed at registration. Please allow 48 business hours to process your registration payment.

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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
(format=mm/dd/yyyy)
Additional Info
Enroll in Classes
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Required Policies and Agreements
I hereby grant permission for my child/children listed above to participate in the activities involved with/at Genia Johnson Dance Company, Inc. By checking this release form, I will not hold the Owner, Teachers, Assistants or any part of Genia Johnson Dance Company, Inc. Center for the Performing Arts, responsible for any mishap or injury, to the student named herein, caused during a class, GJDC Inc. function, GJDC Inc. participating event, or while waiting on the grounds of Genia Johnson Dance Company, Inc. Center for the Performing Arts. If needed, it is understood that the best possible care will be given to my child. In the event of medical treatment being necessary, I give my consent to an authorized representative of Genia Johnson Dance Company, Inc to seek medical aid for my child at the nearest appropriate medical facility and act as guardian in my absence. I am aware that participating in any sport or extra-curricular activity can be dangerous and involve risks and injury.

I do understand that by given the option to pay by monthly installments, the classes being received are NOT pay by month, or class. By signing below, I understand that the total monthly amount of classes are due on or before the dates listed below in the payment schedule, regardless of absence or withdraw, until the total amount owed is paid in full.

I also understand that classes start on September 9, 2019 and run until our Spring Show in May 2020, and that I have until October 11, 2019, to withdraw from classes in writing. The first month's payment, which is due at registration, is NON REFUNDABLE. No exceptions! Withdrawing from classes after October 11, 2019 still binds myself, the parent/guardian/person responsible for account/ the undersigned, for the total amount owed.

If you are taking advantage of the 9, or 12 month payment plan, a credit card number will have to be given and kept on file. The card on file will also be charged in the event of non-payment on the withdrawal date plus the standard $20 late fee on the next business day unless the studio is otherwise notified beforehand. Any leftover balance at the end of the dance term will be charged to the credit card on file, including all 12 month payment plans, in the event we do not receive payment at the end of contract date Automatic monthly withdrawals are available at no additional fee.

There is a $35 Returned Check Charge REGARDLESS OF THE REASON. I authorize Genia Johnson Dance Company, Inc. (GJDC) to initiate a debit entry to my checking account at my bank for the amount rendered on any check made payable to said company and an additional debit entry for $35, or legal maximum, if the item is dishonored. This authorization will remain in full force until GJDC receives written notification from me in a reasonable time to act. If further action is necessary to collect on an account balance, I, the undersigned, will also be held accountable for any collection fees and/or attorney fees associated with Genia Johnson Dance Company, Inc.

All pictures and videos taken in classes, or at any GJDC, Inc. sponsored events may be used for advertising purposes such as, but not limited to, newspaper, media or website.

I hereby authorize Genia Johnson Dance Company, Inc. to charge my card on file monthly until the end of the payment plan option that I have chosen. I understand that my card on file will be charged the remaining amount with with the appropriate late fess until the balance owed is paid in full.

By checking the box below, I understand that the first monthly payment will be applied to the credit card provided within 48 hours of the online registration. All other payments will be withdrawn on the chosen date through the automatic payment schedule chosen.

I Agree to All of the Above
Questions or Concerns
Payment Information
Account Information
Credit Card