PLEASE
READ THE FOLLOWING CAREFULLY
BEFORE YOU SUBMIT THIS FORM ELECTRONICALLY.
1.
Release from liability: I do hereby release
Capital City Dance Center
and its staff from any liability occurring on or around studio premises, or at any
function held at other locations in connection with the dance classes in
which the student named above is enrolled. I declare that the student named
above is in good health and can participate in dance education classes. Given the
nature of dance classes, and with the knowledge that injuries sometimes might occur, I
have taken the necessary steps to obtain accident, health, or hospitalization
insurance which would cover any sustained injury. In the event of an injury or emergency
when I cannot be contacted, I give my permission for you to obtain medical services
for the student named above.
2. Authorization for enrollment: I authorize
Capital City Dance Center to enroll the
student
named on this form in dance classes, and I accept responsibility for the payment of
tuition for those classes for which the student is registered. I understand that
classes with an enrollment of less than six pupils are subject to cancellation.
3. I understand that the curriculum fee for annual classes is non-refundable
and that there are no refunds or deductions for classes not attended.
4. I also accept responsibility for payment of the Spring Performance Fee for the
student named on this form enrolled, unless I give you written notice by December 1 of the school year
that the student will not be participating.
5. I understand that if I do not give written notice of the
student’s withdrawal from classes by the 15th of the month, I am obligated
to pay the next month’s tuition.
By
submitting this form I agree to items 1,2,3,4 and 5 above.
Please mail or
deliver $20 registration fee to: Capital City Dance Center,
2962 99th Street, Urbandale, IA 50322.
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