RHYTHMIC VISIONS DANCE CENTER REGISTRATION FORM

Student’s Name (Last First Middle)

Age

Birth Date

Class Name Day Time

Address (House # & Street)

City State Zip Code

Phone Number
E-Mail Address
Parents/Guardians Name

Relationship to Student

Mother Father
Other (please specify)
Work Number

Ext.
Cell Number
School
Medical History/Injuries
New Dancers – previous years of dance #
Style of dance studied:
Referred by/ how did you hear about RVDC?  
Town Talk Daily Times Phone Book Friend
Summer Program Garnet Valley Press Door Hanger Sign

 

RHYTHMIC VISIONS DANCE CENTER HOLD HARMLESS AGREEMENT

On behalf of myself, my enrolled child(ren) and other family members in my care, I assume responsibility for any injury sustained or loss of property while on the premises of Rhythmic Visions Dance Center or any of its related functions. I agree to hold harmless Rhythmic Visions Dance Center, its director, instructors and any of its agents.

PLEASE TYPE "I AGREE" IN THE FIELD BELLOW

Parents/Guardian Signature Date

 

RHYTHMIC VISIONS DANCE CENTER POLICY & ACCOUNT AGREEMENT

I understand and agree to follow the policies of Rhythmic Visions Dance Center as stated in the Dancer’s Handbook. I understand there are no refunds, credits or deductions for classes missed or discontinued. I may, however, make up any missed class within a one - month period. I understand that I may discontinue my classes and financial obligation to Rhythmic Visions Dance Center at any point in the year by completing a withdrawal form. Please note a (15) day notice is required.

PLEASE TYPE "I AGREE" IN THE FIELD BELLOW

Parents/Guardian Signature Date

 

PHOTO RELEASE

R.V.D.C. is given all rights to use photos/videos, for promotional purposes only, taken of a group or individual by Rhythmic Visions and its representatives during the 2007-2008season.

PLEASE TYPE "I AGREE" IN THE FIELD BELLOW

Parents/Guardian Signature Date

 

RVDC WEBSITE RELEASE

I know & understand it is my responsibility to check the bulletin board and the RVDC website (rvdance.com) weekly for updates.

PLEASE TYPE "I AGREE" IN THE FIELD BELLOW

Parents/Guardian Signature Date

 

 

Please enter the word from the picture below.

 

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