Flat River Dance Company
                                             Summer Sessions 2013
                                                              &
                                    Fall/Spring Registration Form 2013-2014
                                     
 
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: ______________________________________


Princess & Pirate Camp:      July 15th-19th       July 22nd-26th
       
Summer Intensive:               July 15th-26th        August 5th-16th

Open Drop in Ballet Class:    July 8th-11th        July 29th-August 1st

Beginner Pointe Workshop:  July 8th-11th        July 29th-August 1st



All tuition rates per month are as follows for the fall and spring semesters:

Ballet V & Adv. Pointe:  $105        Ballet IV & Int. Pointe: $105           Ballet III & Beg. Pointe: $80
One and a half hour class: $60        One hour class: $45       Forty-five min. class: $40               
Half hour class: $30                        Half Hour Private: $85

Level:       Pre Ballet___   Ballet & Pointe___           Ballet____           Jazz____       Contemporary___

                 Jazz/Funk___      Pas de Deux ___          Contemporary Pointe___        Variations____           

Day(s):     Mon.                  Tues.                     Wed.                   Thurs.                Fri.                Sat.
 
Times:     _________       __________       __________      ___________       __________     ___________   
                                    
________________________________________________________________________________________________________________________________     
Signature of Parent or Legal Guardian                                                      Date 
By signing this, I have read the policy and procedures for FRDC and agree to its contents.

For office use only:
_________________________________________________________________________________________________________________________________________________________

Payment: check#_______________________ or _______________________  cash   Amount $ _____________________________________    Please make all checks out to Flat River Dance Company.