SALISBURY DANCE ACADEMY

105 S. Camden Ave - PO Box 127

Fruitland, MD 21826

410-742-285

REGISTRATION FORM / COSTUME PAYMENT/ DANCE SHOWCASE PARTICIPATION for 2017 2018


Please indicate class choice(s). Either mail this form in or bring to the studio during walk-in registration. You must pay registration fee and first month’s tuition and last month’s tuition for class placement.  Please note:  Class size is limited. SDA reserves the right to change/cancel classes due to class size. It is NOT our policy to give refunds.


FIRST CHOICE        Level___________________________________Day/Time_____________________________
SECOND CHOICE  Level___________________________________Day/Time_____________________________
FEES:                           __________________________               Tuition (1st month & last month- Sept 2017 & May 2018)
                                      __________________________               Tuition 9 months May 2016
                                      __________________________               Registration Fee ($25 Individual OR $30 Family)
                                      __________________________               TOTAL


STUDENT______________________________________________Phone #_____________________________________
MOTHER_______________________________________________Phone #_____________________________________
FATHER________________________________________________Phone #_____________________________________
ADDRESS____________________________________CITY/STATE_____________________________ZIP___________
AGE_______BIRTHDATE_____________________ SCHOOL____________________________________________GRADE_______
PRIOR DANCE EXPERIENCE___________________________________________________________________________________
PARENT EMAIL___________________________________________________________(REQUIRED - PLEASE PRINT)


COSTUME PAYMENTS/DANCE SHOWCASE PARTICIPATION CONTRACT
Salisbury Dance Academy Dance Showcase 2017–2018, June 9, 2018 at Wicomico High School Auditorium
□ My Dancer WILL / □ WILL NOT participate in the 2018 SDA Dance Showcase (CHECK THE BOX)
Costume Deposits are due on October 1, 2017 – there is a $50.00 PER costume deposit required(PSA, PSB, PSC, Primary 1, Primary 2 classes all have 1 costume).  Upper Levels pay by class. (ex:  If your dancer takes Ballet, Tap, Jazz, Lyrical, Modern and Hip Hop you will owe $300 in costume deposits)  NO COSTUMES WILL BE ORDERED UNLESS THE DEPOSIT IS PAID.

                                                                                           Date paid                               Check #
Ballet Costume Deposit $50.00                                        _____________                  _____________
Tap Costume Deposit $50.00                                           _____________                  _____________
Jazz Costume Deposit $50.00                                           _____________                  _____________
Lyrical Costume Deposit $50.00                                       _____________                  _____________
Modern Costume Deposit $50.00                                    _____________                  _____________
Hip Hop Costume Deposit $50.00                                    _____________                  _____________
Musical Theatre Deposit $50.00                                       _____________                  _____________
TOTAL – COSTUME BALANCES                                    ______________

If my dancer leaves Salisbury Dance Academy after October 31, 2017, you will still be responsible for their costume payments. No refunds will be given for costume deposits, to the Parent or Guardian. By signing below, you are agreeing that you have read the terms of the tuition policy and will be responsible for any tuition payments  and costume payments on behalf of the above named student and must be paid by June 1, 2018.  Late fee of $25 will be assessed on past due accounts after the 15th of each monthReturned check fees are $25.00.  *If your dancers tuition is not paid for 3 consecutive months your dancer will not be permitted to attend classes until the tuition is paid in full.*
Parent or Guardian signature required if student is under the age of 18

______________________                     __________________________                           __________________
         Dancer signature                                     Parent/ Guardian Signature                                            Date

OFFICE USE ONLY:
Class Level__________________________ Day/Time_______________________Tuition_______________Reg. Fee_________
Cash_______________________________ Check#___________________________