2014-2015 Registration Form
2014-2015 Registration Form
2014-2015 Registration Form
Dancers Name:::::::::::::::::::::::::::::::::Date of birth:::::::::::;rade 'Fall +,*%-:::::::: $ailing Address::::::::::::::::::::::::::::::::::::::::<&mail Address:::::::::::::::::::::::: City::::::::::::::::::=ip:::::::::::>hone:::::::::::::::::::::::Cell :::::::::::::::::::::: arent!"uardian Name#s$:%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%% Address and >hone 'if different than dancers- ::::::::::::::::::::::::::::::::::::::::::::::::::::: (ew to Jeune Attente Dance Company? @<" (A Bf new pre)ious dance e!perience0 ::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: $edical conditions the instructor should be aware of0 :::::::::::::::::::::::::::::::::::::::::::::: &egistrati'n (ees #)'stume d'*n-payment$ @our child will be considered registered and a spot will be held for himCher once the costume fee has been paid. Registrations must be postmarDed or recei)ed by July *6 +,*%. A +50 late ,ee *ill be added ,'r registrati'ns p'stmar-ed 'r recei.ed a,ter /uly 15, 2014 . >lease maDe checDs or money orders payable to JADCA for the amount below0
>reschool E 6th ;rade0 Registrations recei)edCpostmarDed by July *6 +,*%0 3%,.,, each dancer Registrations recei)edCpostmarDed after July *6 +,*% 3F,.,, each dancer 4th ;rade E Gigh "chool0 Registrations recei)edCpostmarDed by July *6 +,*%0 34,.,, each dancer Registrations recei)edCpostmarDed after July *6 +,*%0 3**,.,, each dancer :::::::::: :::::::::: :::::::::: ::::::::::
H@our costume fee is non&refundable after "eptember 2, +,*%. Class times will be assigned following the registration deadline. @ou will recei)e a mailing that will state your class le)el and dance fees along with further information. 0'ur registrati'n ,ee d'esnt include any part ', y'ur tuiti'n1 2 *ill n't 3'ld t3e (ine Arts Department, t3e Dysart 4'mens )lub, t3e instruct'rs, 'r any member ', t3e /eune Attente Dance )'mpany parent b'ard resp'nsible in case ', accidents 'r in5uries t3at 'ccur during dance class1
Choose *0 B plan to maDe payments for dance monthly ::::::: semi&annually::::::::yearly::::::: B willC will not allow my childs picture to be posted in the newspaper or on a JADCA internet site. "ignature of parentCguardian::::::::::::::::::::::::::::::::::::::::::Date::::::::::::::
lease c'mplete t3is ,'rm and attac3 y'ur payment1 6ail t' /enn Alpers, 1207 4ils'n1, Dysart, 2A 522241 8uesti'ns9 )all /enn Alpers at #641$751-51061