Flat River Dance Company
Registration Form
Season 2010-2011
Name: ______________________________________________ Date of Birth: ______________ Age:_______________
School Attending: _______________________________________________________ Grade:_____________________
Number of Years Dancing: ________ Where: ____________________________________________________________
Parent/Legal Guardian(s): _____________________________________________________________________________________
Allergies/Medical Info: ___________________________________________________________________________________________
Emergency Contact: _____________________________________________Phone: _______________________________________
Home #: ________________________________________ Cell #:___________________________________________________
Address: _____________________________________________ Email:________________________________________________
City: ___________________________________________ State: ______________ Zip: _______________________________
Work:_____________________________________ Phone: ______________________________________
All summer and fall classes require a non-refundable registration fee of $15 per student/$25 per family. Please circle the classes
you are interested in for Fall Registration:
Pre Ballet Jazz
Ballet Pointe Contemporary Men/Boy's Class
Variation/Comp
Day(s):
Monday Tuesday Wednesday Thursday Friday
Time(s): ______________ ______________ ______________ ______________ ______________
Time(s): ______________ ______________
______________ ______________ ______________
All tuition rates per
month as follows:
1 1/2 hr. class $50
1 hr. 15 min. class $44
1 hr. class $37 45
min. class $30 30
min. class $22 Private ½ hr. $72
Semi-private ½ hr. $57
Ballroom $50
Payment: check (check#__________) or cash Please make checks out to Flat River Dance Company.
________________________________________________________________________________________________________________________________
Signature of Parent or Legal Guardian Date
By signing this, I have read the policy and procedures for FRDC and agree to its contents.
ALL DATES ARE SUBJECT TO CHANGE OR ADDITIONS MAY BE MADE THROUGHOUT THE YEAR. PLEASE CHECK BACK OFTEN TO STAY CURRENT ON THESE CHANGES AND WATCH THE BOARD AT THE STUDIO.
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