Use the form below to enroll for the 2010-2011 Season. Enroll early to reserve class space. Note: Students taking more than one class will receive a "multi-class discount". Please note: This discount also applies to classes taken by immediate family members. See "FEES & TUITION" for clarification. 2010-2011 ONLINE REGISTRATION FALL CLASSES BEGIN AUGUST 2, 2010. You may register until classes are full. **Watch for additional NEW Classes beginning in October 2010!
2010-2011 Registration - When enrolling more than one student, please fill out this form for each student.
Full Name of Student
Date of Birth
Age Today
Name of Parent/Legal Guardian (If Student is under 18 years of age)
Address	Street: City: State:    Zip:
Home Phone Number
Mobile Phone Number
Email Address
Emergency Contact Name
Emergency Contact Phone Number
List any previous experience.
How did you hear about us?	Internet Yellow Pages Community Event Recital Friend/Relative Other
If you were referred by a current Expressions student or instructor, please tell us who so we may thank them:
This Form will Register you for the Regular Class Schedule which begins AUGUST 2010. CLASS PLACEMENT - Dancers are placed by age and skill level. Age Guideline for Dance Classes - Use the age of the dancer as of August. 1, 2010 when selecting the class age group. ADVANCED PLACEMENT - Dancers may enroll in a Level III or Pointe Class only with teacher approval. If you have not already received approval, please enroll in a level 1 & 2 class and the instructor will make any needed class changes after assessing your skill level. Dance students that enroll after Jan 15, 2011 may not be able to perform in the Spring Recital (will depend on student's ability to learn the choreography in a short time frame, as well as costume availability.)
DANCE CLASSES - Classes shown have space available.
Age 3-5 Classes (45 min. classes)	Ballet/Tap Mon. @4:00 Ballet/Tap Wed. @4:00
AGES 6 - 9 (45 minute classes)	Tap Tues. @ 4:00 Jazz Wed. @4:00 Acro Thurs @ 4:00 Hip Hop Thurs. 5:00 Vocal Thurs. 5:00
Ages 6-9 WAITING LIST- The classes listed are full. Select to be placed on the waiting list.	Ballet Mon. @ 4:00
Age 9-13 Classes (50 minute classes)	Ballet I&II Mon @ 5:00 Ballet III Mon @5:00 Tap I & II Tues @5:00 Tap III Tues @6:00 Jazz I&II Wed @5:00 Jazz III Wed @6:00 Acro Thurs @ 4:00 Vocal Thurs @ 5:00 Hip Hop Thurs @ 6:00
Ages 9-13 ***NEW Class starting in October. Our current Ballet Level I & II class is full... so, we're adding another class that will begin in October. Click here to register.	Ballet Level I & II Mon. @ 5:00
Age 14-18 Classes (50 minute classes)	Ballet I&II Mon.@6:00 Ballet III Mon.@6:00 Pointe I&II Mon.@7:00 Pointe III Mon.@7:00 Tap I&II Tues.@7:00 Tap III Wed.@6:00 Jazz I&II Wed.@7:00 Jazz III Tues.@7:00 Hip Hop Thurs@7:00 Vocal Thurs@ 5:00
ADULT Classes (50 minute classes) These Classes are scheduled to Begin in October when we open our NEW facility at 5288 Seminole Blvd. These classes will NOT perform a routine in the spring recital.	Cardio Jazz Wed. @6:00 pm Contemporary Ballet Wed. @7:00 pm
Technique Classes (50 minutes) Technique Classes are available at $15.00 per class (must pay at least 2 days in advance). Dancers who wish to take Technique must also be enrolled in a regular dance class at the studio. Wednesdays @ 7:00 The class will alternate weekly: Core Strength, Technique, Stretch & Flex
VOCAL CLASSES - Group setting with professional instructors. Ages 7 - 18 male/female classes. Classes shown have space available. Students enrolled in Vocal Classes will perform at the Annual Cast Party. There may also be other opportunities to perform at community events.
VOCAL CLASSES for ages 7 - 18. Students should bring a water bottle to class. Students should also bring a song on a CD or I-Pod. Multi-class discount also applies to vocal & guitar classes.	Thursdays @ 5:00 (45 min. class)
STUDIO POLICIES (Please read and acknowledge)
REGISTRATION FEE- All students are required to pay an annual registration fee of $35.00, or a “Family Fee” of $50.00 for students of an immediate family. (After 12/15/10 the Registration Fee is Pro-Rated.) Payment of the registration fee is required and registers students through May, 2011. After submitting this online Enrollment Form, you will have 5 business days to submit payment of the registration fee. This is needed to hold your class space, as classes are capped and on a first come basis. You may mail in or drop off a check, or you may elect to pay with VISA, MASTERCARD, DISCOVER,AMERICAN EXPRESS, or ONLINE CHECK.
PAYMENTS & LATE FEES - All payments are due by the first class of the month. A $10.00 late fee will be added to any outstanding balance after the 10th of the month. Students with an outstanding balance after the 15th of the month will be asked to sit outside until payment is received in full. If postmarked by the 10th, no late fee will be assessed. We accept CHECKS and MONEY ORDERS at the studio. We also accept payment by VISA, MASTERCARD, AMERICAN EXPRESS, DISCOVER CARD, and ONLINE CHECKS via our website. Your first class is $50/month. Each additional class is $40/month. The discounted class rate also applies to classes taken by siblings.	Yes - I understand.
PRIVATE LESSONS (available for registered students only) - We offer private lessons in Keyboard, Drums, Guitar, Bass, Saxophone, Vocal, and Dance. To schedule a private lesson, please click on the PRIVATE LESSONS button.
PERFORMANCES for Students enrolled in a Vocal Class - Students will perform at the annual cast party (in May). Vocal students may also be invited by the instructor to participate in community performances and/or the Spring Recital.	Yes - I understand.
PERFORMANCES for Dance Students - All Students enrolled in a Dance class will perform in a Spring recital, (usually in May). Each Dance Student will pay a recital committment fee of $85 per class due by October 15th. If you have any questions, please review the Fees & Tuition Information at this time. This fee is NON-REFUNDABLE and viewed as your commitment to participation in the Spring recital. Costumes will be distributed in class, approximately one week prior to the performance. Dancers will need to supply their own tights and shoes for the recital. All DANCERS ARE REQUIRED TO ATTEND CLASS DURING THE TWO WEEKS PRIOR TO A PERFORMANCE. Recital Tickets are made available approximately 3 months prior to the performance date and are available online.	Yes - I understand.
CHOREOGRAPHY - Dancers learn and perform original choreography. This choreography is under the ownership and copyright of the instructor and is not permitted for use outside the studio without written permission from the instructor. Occasionally, dancers will have school talent shows and other functions for which they would like to use a routine learned at the studio. Seek written permission before doing so. For team and competition purposes, some routines may not be permitted for use outside the studio.	Yes - I understand.
REQUIRED ATTIRE - Please take time to become familiar with the required attire. Students will be asked to sit out of class if they continually come to class without the required attire. We ask for your cooperation. No chewing gum! No soda or food items are allowed inside the studios. Water bottles with lids (and student's name) are allowed and encouraged. Dance students may not wear dangling earrings or necklaces. All students must pull back hair, neatly pinned away from the student's face and eyes. These policies will be STRICTLY ENFORCED.	Yes - I understand.
WE WANT YOU TO HAVE HIGH QUALITY VIDEOS OF THESE IMPORTANT MEMORY MAKING ACTIVITIES! VIDEO & DIGITAL PHOTOGRAPHY OF CLASSES, RECITALS, AND PERFORMANCES IS PROHIBITED. PLEASE READ OUR VIDEO/PHOTO POLICY. IF YOU HAVE ANY QUESTIONS, PLEASE CALL THE STUDIO AT 392-5678.
Video and digital photography of recitals, performances, and regular classes is prohibited. The studio will contract with a professional for these services. Each family will receive a complimentary DVD of the Spring Recital. Additional DVDs may be purchased, if desired. I hereby give permission for my image (or my minor child's image) to be captured during regular and special Dancing activities through video, photo and digital camera, to be used solely for the purposes of Expressions Academy of Dance, Inc. promotional material, publications, and internet usage and waive any rights for compensation or of ownership of such images.	Yes - I understand and agree.
BACK STAGE VOLUNTEERS - The studio's staff will select parent volunteers to assist back stage. There shall be a minimum of 2 volunteers assisting with the supervision of children ages 5 and under. There shall be a minimum of 2 volunteers assisting with ages 6 - 10. All back stage volunteers selected will go through an approval process. If you would like to be considered for a position as a backstage volunteer, please fill out an application at the studio.	Yes - I understand and agree.
IMPORTANT - ADDITIONAL DRESS REHEARSAL & RECITAL POLICIES
ADDITIONAL DRESS REHEARSAL & RECITAL POLICY. All dancers are required to attend dress rehearsal. Dress rehearsal is usually held the evening before the recital. This helps ease the butterflies and makes the experience of performing very enjoyable! Note: Dress rehearsal is CLOSED to spectators/parents. In addition to the dance learned in class, all dancers will perform in the grand finale. Dancers are dismissed at the END of the performance. Dancers are NOT ABLE TO LEAVE OR BE PICKED UP DURING INTERMISSION OR WHILE THE PERFORMANCE IS IN PROGRESS. There just is not enough time during intermission for staff to take the time needed to transfer students to their parents. Staff is very busy during intermission. We are preparing for the second half of the performance. For the safety of all dancers, parents are not permitted back stage for any reason. Only staff members and approved volunteers will be permitted into the back stage area.	Yes - I understand and agree.
Annual Cast Party - This event is held the same weekend as the Spring Recital and includes a dinner banquet with entertainment by our vocal students. There will be door prizes, contests, and our awards presentation. All students and family members should plan to attend! It is a great way to celebrate the end of the dance year and the accomplishments of our students! There will be good food & fun for all! Tickets will go on sale around February/March and are typically $15
ACKNOWLEDGEMENT OF RISK, WAIVER OF LIABILITY, AND INDEMNIFICATION
PARENTS OF ALL STUDENTS MUST ACKNOWLEDGE. ACKNOWLEDGEMENT OF RISK, WAIVER OF LIABILITY, AND INDEMNIFICATION - I hereby consent to participating in (or my child's participation in) Expressions Academy of Dance/ Dance Programs. I recognize that potentially severe injuries can occur in any activity involving height or motion, including leaping, spinning, jumping, stretching, and other related dance movements. In consideration of allowing my child to use these facilities, I hereby forever release Expressions Academy of Dance, its instructors, its employees, or any volunteers from any and all liability, for any and all damages, and for injuries suffered by my child while under the instruction, supervision, or control of Expressions Academy of Dance, its instructors, its employees, and other volunteers.	Yes - I understand and agree.
Your Medical Insurance Carrier
Policy#
Name of Primary Insured
Are there any previous Medical Conditions that we should be made aware of, or that may be caused by Physical Exertion?	Yes No
If so, please explain.
Have you ever broken any bones?	Yes No
If so, when? How many times? Which bones?
ELECTRONIC SIGNATURE
Please enter your first and last name in the box provided to serve as your electronic signature acknowledging that you understand and agree to all terms listed above.