2022 Summer registration form

Student’s Last Name: (required)

Student’s First Name: (required)

Mailing Address (required)

City (required)

State (required)

Zip Code (required)

Apt Number (required)

Student's Age (required)

Student's Date of Birth (required)

Student's Gender (required)
malefemale

Class/classes selection
Add your class selection here..

Parent/Legal Guardian Name: (required)

Parent/Legal Guardian First Name: (required)

Home Phone

Cell Phone

Work Phone

Parent/Legal Guardian Email: (required)

Emergency Contact - Primary Name (required)

Emergency Contact - Primary Cell Phone(required)

Emergency Contact - Secondary Name

Emergency Contact - Secondary Cell Phone

Medical Information
Insurance Company

Important medical conditions to be aware of

I understand that, Miss Tanya’s School of Dance and its faculty are not liable or assume responsibility for personal injuries, damages, or loss of personal property. I understand that it’s required that my child is to be covered by my insurance and if injury occurs and is also understood that my own policy is the only source of reimbursement. A separate Covid 19 waiver form will be required to fill out and sign for each student. The separate Covid waiver form is on our Website for all in studio classes.

Tuition is a set rate, based on a 5-week session. Tuition is non-refundable and will not be prorated to accommodate for missed classes. I understand that at any time during the 5-week season, if necessary or mandated by the state, governor or mayor the studio may have to change from in studio classes to online classes via Zoom. *Class size is limited and is accepted on a first come first serve basis. You will be notified if the class that you registered for is full and we will try to find another class. Registration fee for all NEW students is $5.00 and there is a $30.00 deposit due upon registration. The deposit will be deducted from the tuition. The balance of tuition is due the first week of class. Registration fee and deposit must be paid when the form is submitted.

Enter your name to confirm registration as a Parent/Legal Guardian (required)

Date of registration (required)

*Office staff will calculate the monthly tuition

Please note: The Registration Fee is $5 and $30 deposit due which needs to be paid online by visiting Payments Page after submitting this form. The registration will be complete only after submitting this form and the 2021-2022 Credit Card information form. Please provide Student's name as mentioned in the registration form and write "2022 Summer Registration - 5 Week Program" in Reason of Payment