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BSD Online Registration Form
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Student Name:
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Date of Birth:
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Age:
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School:
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Grade:
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Parent/ Guardian Names:
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Email Address:
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Phone Numbers:
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Mailing Address:
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Please contact Natasha for dancer placement prior to online registration for classes.
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SUMMER COURSES
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SUMMER CAMPS 2011 & Belly Dance
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SUMMER DANCE
CARDS 2011
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SUMMER POINTE
CARDS 2011
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Classes Registration 2011-2012
September 2011-May 2012
Registration Fee due to hold place in class.
Registration Fee
$35 Plus $10 each additional student
Please contact Natasha for class placement (natasha@dancenc.com)
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200 Level Classes
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100 Level Classes
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300 Level Classes
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400 Level Classes
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Adult Sessions
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Waiver of Liability
I, the undersigned parent or legal guardian of the dancer(s) listed above, do hereby give permission for the
aforementioned persons to participate in any and all classes, programs, shows, and events offered by or
attended by Betty's School of Dance. I accept all risks associated with that participation and understand that
there is a full possibility of serious physical illness or injury. I hereby covenant not to sue and waive, release
and forever discharge any and all rights and claims for damages, which may arise now or in the future against
Betty's School of Dance and all of its officers, owners, teachers, directors, employees, and/or other assigned
representatives or volunteers from any and all liability and for any and all damages and/or injuries which may
be sustained or suffered by the dancer(s) listed above while participating at or for Betty's School of Dance.
Acceptance of Studio Rules and Regulations
By submiting this online registration form I state that I have read, understand and will abide by all rules and
regulations that are set forth by Betty's School of Dance, which can be found in the studio handbook. I
understand that these policies may be changed, added, or updated as needed by the studio owner. I agree to
check the website www.dancenc.com and/or the studio bulletin board weekly for all updates to policies and
payment schedules. I understand that all monthly tuition is due on the first day of the month of service, except
for the final month of the term, which is due upon registration. Penalty fees apply to payments received after the
initial due dates. Summer tuition must be paid in full upon registration. All tuition, fees, and other payments to
Betty's School of Dance are non-refundable and non-transferable. The undersigned parent or acting guardian
agrees to be held responsible for all the tuition and fees for the entire season. Students may withdrawl from
classes only by filling out and returning the "Intent to Withdraw Form" available via the web or in the studio or by
giving one month's written notice to the studio owner. Only tuition and fees due after this date will be excluded
from charge to the student's account. I also understand that students must adhere to all attendance and studio
policies in order to participate in performances, camps, and classes.
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By typing my name in the field below, I confirm my agreement to abide by the policies listed below. I
also agree to be responsible for the registration of the student on this form. I understand that my
registration is not complete until I have paid the required registration fees or deposits.
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Methods of Payments
- Paypal (credit/debit) payments through electronic invoice
- Checks mailed to the studio address: 236 East Front Street/ Statesville, NC 28677
- Cash or check payments at the front desk.
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