Name of Student:   Age:   DOB:   
 
Years of Dance Experience:
 
Parent's Name:
 
Email Address:
 
Home Address: 
 
Home Phone Number: 
 
Work Phone Number: 
 
Cellular Phone Number: 
 
In case of emergency – please contact:

Siblings enrolled: 

Please list any allergies (to include food) and medical conditions the staff should be aware of: 

How did you hear about Making Moves Dance Collective?

Please enter the classes that you are registering for:
Class 1:         Class 2:

Class 3:         Class 4:

Class 5:        Class 6:

Please initial the boxes below:

I have read and understand the MMDC policies and procedures to include the fact that MMDC is a competitive entity and that select choreography may be taken to competition and that competitions have separate fees involved to include separate practice time which must be paid for in advance.  I understand if my child is selected for competition she/he will be required to purchase a MMDC warm up jacket to wear.

I agree to support at least two (2) of MMDC’s fundraising efforts to help offset recital costs.  Failure to do so will result in my account being charged a $50.00 recital fee.

I agree to abide by the MMDC costume payment schedule and will make the following timely payments: initial deposit of $50 due 10/17/09; $35 2nd deposit payment due by 12/16/09 and the remaining balance in full by 02/20/2010.  Additionally, I understand all costume deposits made are non-refundable as costumes are non-returnable and it is my responsibility to verify/discuss/suggest what size costume should be ordered for my child.  If my child’s costumes needs alterations, I am aware it is my responsibility to pay for and/or make the necessary alterations. 

I understand that like any physical activity there is a certain risk of injury involved in the art of dance.  Making Moves Dance Collective is not liable for injuries suffered by my child.

I understand and agree that staff members of Making Moves Dance Collective may take photos or video tape my child for use in promotional materials or on the studio website.

Please read our Studio Policies:
I have read and agree to abide by the studio policies of Making Moves Dance Collective.