Registration Form

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Dance Dimensions
201-967-2928

director@dance-dimensions.net

Main Studio:
516 River Road
New Milford, NJ 07646

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201-967-2928

Email: *

ONLINE REGISTRATION FORM

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Sibling Birthdate:

City, State, Zip Code *

Parent's Signature (please type full name): *

Additional Dancer (sibling):

Address: *

Sibling Grade (Sept '24):

Class Selection: *

Dancer's Name: *

Amount to be Paid (first payment and registration fee):

Name on Card: *

Dancer's Birthdate: *

CVC Code: *

Credit Card Number: *

How did you hear about us?"

Parent's Name: *

Grade (Sept '24): *

Home Phone:

Billing Zip Code: *

Medical Problems or other pertinent information:

Policies & Procedures: *

I have read the policies and procedures of Dance Dimensions. I understand that after the second lesson, there are no refunds issued, the registration fee is nonrefundable and there is a $30 drop fee. I understand that I will continue to be billed for all classes unless I notify the school that my child will not be continuing lessons. I understand that is the studio is forced to close down as a result of a State of Emergency or Public Health Emergency pursuant to any order by any Federal, State or Local authority, this agreement shall remain in full force and effect and the classes will be converted from in studio classes to virtual classes by an online platform such as Zoom. If this occurs, no refunds or credits will be given as classes will continue to be offered. I understand that all payments must be completed before costumes/tickets are released. I understand that students are expected to have their own accident and medical insurance. The instructors at Dance Dimensions will follow all safety procedures and be held harmless from liability or laims resulting in participation of this program. I understand throughout the year photos and videos of my child may be taken and used for publicity purposes.

Expiration Date *

Cell Phone: *

Health Release Form: *

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and I may be exposed to or infected with COVID-19 by attending Dance Dimensions in-person classes, and that such exposure or infection may result in personal injury, illness, permanent disability, and death. Although Dance Dimensions has taken measures to keep all children and parents safe, I understand that exposure to or infection with COVID-19 at Dance Dimensions may occur from the actions, omissions, or negligence of myself and others, including, but not limited to, Dance Dimensions owners, teachers, employees, agents, representatives, volunteers, students and their families. I voluntarily agree to assume all of the foregoing and other related risks and accept sole responsibility for any injury to my child(ren) or myself, including all illness, death, damages, loss, claim, liability or expense of any kind, that I or my child(ren) may experience or incur in connection with my or my child(ren)’s attendance or presence at Dance Dimensions (“Claims”). On my behalf, and on behalf of my children and other household members, I hereby release, covenant not to sue, discharge, and hold harmless Dance Dimensions, its owners, teachers, employees, agents and representatives, of and from the Claims. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of Dance Dimensions, its owners, teachers, employees, agents, and representatives, whether a COVID-19 infection occurs before, during or after participation or presence at Dance Dimensions. I further acknowledge and agree that this form and agreement is supplemental to the other regular policies and procedures of Dance Dimensions.

Registration Form

Billing Information: *

By checking this box, I acknowledge that my credit card will be kept on file for future payments. If I do not want this card to be processed, I will submit a payment prior to the due date.

516 River Road

New Milford, NJ 07646

· 201-967-2928 ·

516 River Road. New Milford, NJ 07646

Annex:
120 Woodbine Street
Bergenfield, NJ 07621