Hot Styles Dance Studio Online Registration

Registration

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Welcome to Hot Styles Dance Studio! Please complete the following registration form.

* 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*

Contact #1

Contact #1 First Name*

Last Name *

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

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

Allergies*

Skill Notes

Please click on the Search button below, then choose the class.

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

Allergies*

Skill Notes

Please click on the Search button below, then choose the class.

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

Allergies*

Skill Notes

Please click on the Search button below, then choose the class.

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

Allergies*

Skill Notes

Please click on the Search button below, then choose the class.

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

Allergies*

Skill Notes

Please click on the Search button below, then choose the class.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Hot Styles Dance Company Release and Wavier

I understand that there are risks of physical injury (including but not limited to cuts, sprains, broken bones and/or catastrophic injury) associated with, arising out of, and inherent to the activity taking place with this program. In recognition of this acknowledged risk of injury, I knowingly and voluntarily waive all rights and/or causes of action of any kind, including any and all claims of negligence, arising as a result of such activity from which liability could accrue to Hot Styles Dance Company, its officers, agents, employees, instructors, subsidiaries, and all affiliated entities (hereinafter collectively referred to as Hot Styles Dance Company).

I hereby agree to release Hot Styles Dance Company and hold them harmless of all liability, and hereby acknowledge that I knowingly and voluntarily assume full responsibility for all risks of physical injury arising out of active participation in this program.

I am aware that this is a release of liability and acknowledgement of my voluntary and knowing assumption of risk of injury. I have checked this document voluntarily and of my own free will in exchange for the privilege of participation.

I've read the above and agree.

Photo Release

I hereby grant permission to the rights of me/ my child(ren)'s image, likeness and sound of their voice as recorded on audio or video tape without payment or any other consideration. I understand that me/ my child(ren)'s image may be edited, copied, exhibited, published or distributed and waive the rights to inspect or approve the finished product wherein me/ my child(ren)'s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of me/my child(ren)'s image or recording. I also understand that this material may be used in diverse educational settings within an unrestricted geographical area.

By checking this release I understand this permission signifies that photographic or video recordings of me/ my child(ren) may be electronically displayed via the internet.

I will be consulted about the use of the photographs or video recording for any purpose other than those listed above. There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. This release applies to photographic, audio or video recordings collected as part of the sessions listed on this document only.

By checking this form I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release any and all claims against any person or organization utilizing this material for educational purposes.

I've read the above and agree.

Payment Policies

Tuition payments are due on the 1st of the month by cash, check, credit card transaction. Any and all payments not received by end of business on the 15th of the month will accrue a $30 Late Payment Fee.

Withdrawals from classes must be received by Hot Styles Dance Company staff no later than the 20th of the preceding month in writing via email or in person at the front desk. All notifications of withdrawal received after the 20th will result in a $35 Late Withdrawal Fee. Notification of withdrawal received after the 2nd of the month will result in the full months tuition being charged. No refunds for late withdrawals will be given.

By checking this form I acknowledge that I have completely read and fully understand the above payment policies and agree.

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