Prodigy Dance and Performing Arts Inc. Online Registration

Registration

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Welcome to Prodigy Dance and Performing Arts Registration.

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Referral Information

How did you hear about us?*

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

Postal Code*

Home or Primary Phone*

Additional Info

Emergency Contact Info
(Not Contact #1 or #2)*

Health Insurance Carrier

Contact #1

Contact #1 First Name*

Last Name *

Relation*

How Can We Contact You?

Home Phone *

Work #

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*

Relation*

How can we contact you?

Home Phone

Work #

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

Grade Level

Disabilites

Special Needs*

Allergies*

Medications*

Primary Doctor*

Please make your class choices and submit for availability.

Enroll in Classes

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Grade Level

Disabilites

Special Needs*

Allergies*

Medications*

Primary Doctor*

Please make your class choices and submit for availability.

Enroll in Classes

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Grade Level

Disabilites

Special Needs*

Allergies*

Medications*

Primary Doctor*

Please make your class choices and submit for availability.

Enroll in Classes

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Grade Level

Disabilites

Special Needs*

Allergies*

Medications*

Primary Doctor*

Please make your class choices and submit for availability.

Enroll in Classes

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

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

Additional Info

Grade Level

Disabilites

Special Needs*

Allergies*

Medications*

Primary Doctor*

Please make your class choices and submit for availability.

Enroll in Classes

Add Another Student

Required Policies and Agreements

Please read below and accept to submit

I hereby declare that I am the parent or legal guardian for the above registered student/students.

If you are an individual registering for an adult class, you hereby declare that you have read and fully understand all applicable terms and accept these terms by signing below.

I've read the above and agree.

Prodigy Parent Code of Ethics

At Prodigy we ask that everyone follow a simple code of conduct that makes our studio and our events enjoyable for everyone. Thank You

I recognize the importance of the performing arts in the lives of young people; I pledge that I will participate in my child's dance activities in a positive manner and in accordance with the following:
• I will promote teamwork and sportsmanship for all students and spectators in a positive manner.
• I will support my child's class, teachers, choreographers and studio management and resolve to allow the teachers to manage their dancers and choreography as they feel best benefits the entire class.
• Because I am a role model for my child as well as other dancers, my personal conduct at the studio, performances and other studio events must be above reproach, and represent the highest standards of morality, teamwork and sportsmanship.
• I will exhibit positive behavior at the studio and studio events. I will at all times control my emotions and will be considerate of all dancers, teachers and parents' collective emotions.
• I will not make disparaging remarks of any type with regard to teachers, choreographers, choreography, dancer placement, costumes, dancers, other parents or their children in the studio or at any dance event (whether from Prodigy Dance Studios or another school).
• I commit to only speaking in a positive manner on Prodigy premises, which will encourage our team and our dancers.
• I will not interact with anyone at Prodigy in a manner that is intended to provoke hostility.
• I will not make a judgment on my child's performance and will always be there to support them. I accept this "Parent Code of Ethics" on behalf of myself and my dancer's other parent/guardian. We agree to conduct ourselves according to the principles and policies of Prodigy Dance Studios. I understand that parents/guardians or dancers may be removed from any dance event or the Prodigy studio for failure to comply.

I've read the above and agree.

Parent Statement

I hereby state that the dancer / dancers I am registering for is in good mental and physical health condition to participate in the activities provided by Prodigy Dance and Performing Arts Inc. including but not limited to all aspects of lifts, acrobatics, tumbling, dance training, and all outside activities. I am fully aware that any activity involving motion, height or athletic activity creates the possibility of serious injury.

I understand that Prodigy Dance and Performing Arts Inc. has the right to deny admittance to any student not meeting the standards of the program as it sees fit. I also agree not to hold these parties responsible in the event that my son/daughter/child engages in inappropriate conduct (including, but not limited to disruptive or volatile behavior in or out of Dance, etc.) or becomes involved in any activity or with any persons not associated with Prodigy Dance and Performing Arts Inc. or its scheduled program and that Prodigy Dance and Performing Arts Inc. has the right to send him/her home for inappropriate conduct. No refunds will be given. I further attest that the information contained in this application is correct to the best of my knowledge. In addition, I have agreed to the policy and fee statement and agree to comply.

I've read the above and agree.

Photo and Recording Permissions

I hereby give permission for images of my child / children, captured during his/her dance classes, dance events and annual recitals
through video, photo, and digital camera, to be used solely for the purposes of Prodigy Dance and Performing Arts, Inc.
promotional material and publications, and waive any rights of compensation or ownership thereto.

I've read the above and agree.

Emergency Permissions

You have my / our permission, in the event of an emergency and in case we are unavailable, to authorize any physician, nurse practitioner or medical personnel to examine, interview, test and if necessary, treat my child as they may deem advisable.

I've read the above and agree.

Cancellation Policy

Prodigy management must receive a written letter no more than 30 days after the first paid class attended. After the 30 days, No cancellations will be accepted. If cancelling after the 30 days you will be responsible for the remainder of the dance season. The remainder of the classes will be paid by continuing monthly payments or paying the remaining amount in full upon cancellation. No exceptions will be made.

I've read the above and agree.

NSF and Late Payments

If a payment does not go through (NSF), you will be charged a $30 fee. If a payment is missed a second time in that month, you will be charged a $60 fee in addition to your outstanding monthly payment. The owing fees are to be paid in cash before anymore classes can be attended.

All regular dance season payments (September to June) are due on the first of each month. All other payments including but not limited to Costumes, Photography, Choreography, Special events, Competition fees will be presented with a payment due date. Payments not submitted by studio closing on the due date are considered late. Failure to pay by the dates presented to you will result in an automatic $20.00 late payment fee that will be charged to the credit card on file with Prodigy, there will be no exceptions.

I've read the above and agree.

Student Liability Waiver

I/we realize that participation in dance classes and activities could involve some possible personal injury. Despite precautions, accidents and injuries may occur. By agreeing to this release form, I/we (the dancer and parent/guardian) assume all risks related to the use of any and all spaces used by Prodigy Dance and Performing Arts Inc.

I/we agree to release and hold harmless Prodigy Dance and Performing Arts Inc., including its teachers, dancers, staff members and facilities used by Prodigy Dance and Performing Arts Inc. from any cause of action, claims, or demands now and in the future. I/we will not hold Prodigy Dance and Performing Arts Inc. liable for any personal injury or any personal property damage, which may occur on the premises before, during or after classes. Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Prodigy Dance and Performing Arts Inc.

I understand that Prodigy Dance and Performing Arts Inc. is licensed, accredited and insured. In the event that I/we should observe any unsafe conduct or conditions before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the Executive Director, Artistic Director, Individual Instructor or staff member as soon as possible.

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

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Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State/Prov

Postal Code*