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Registrationkatie2023-10-25T21:18:58-04:00

Registration (2023)

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General Student Information
Student Name*
First Last
Date of Birth*
Age*
School attending
Grade
Student(s) Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Mother/Guardian Name*
First Last
Mother Phone Number*
Mother Alt Phone Number
Mother/Guardian's Email Address
Father/Guardian Name
First Last
Father Phone Number
Father Alt. Phone Number
Father/Guardian's Email Address

Person Responsible for Payment
(if other than parent/guardian)
Name
First Last
Address
Street Address Address Line 2 City ZIP / Postal Code
Phone
Emergency Contact
(other than parent/guardian)
Emergency Contact Name*
Relationship to student*
Emergency Contact Phone*
Emergency Contact Cell Phone

Does student have an IEP or need assistance to participate due to a disability?*
- Yes
- No
If yes, please explain
Does student have any behavior problems we need to be aware of?*
- Yes
- No
If yes, please explain
Describe any other medical condition you feel we should be aware of .
(ie: diet restrictions, allergies, asthma, etc.)

How did you hear about us?*
Is this the student's first year of dance?*
- Yes
- No
Years of dance completed
Former dance school(s)
Class Interests
Please tell us all of the classes you are interested in trying and/or enrolling in:
Class Day(s) & Time(s)

Click the plus symbol to the right to add another class.
We the staff of A & G Dance Academy, recognize our obligation to make sure our students and their parents are aware of the risks and hazards involved in the sport of dance. By signing this waiver, you release A & G Dance Academy and all its employees from all claims on account of any injury which may be sustained by your child while attending any dance class, event associated with A & G Dance Academy or outside performance. In signing this waiver, you also acknowledge your responsibility in paying monthly tuition, any associated costumes, entry fees for performance and competition and all other communicated costs involved. You also affirm you now have, and will continue to carry, proper primary medical, health, and hospitalization and accident insurance, which you consider adequate for the protection of both your child and A & G Dance Academy.
- I have read and understand the above statement.

Parent Consent Form
Please initial the box next to each statement, acknowledging you read, understand and agree to the terms.
*
- Payment of tuition is DUE ON THE 15th of the month. Payment of tuition secures enrollment for your child in class. We do not send statements, however we do post tuition reminders around the studio.
*
- You have until the 15th of each month to pay tuition. On the 16th, we will add a $20 late fee and run your credit card on file unless we have received a “DROP” form or written notification dropping the child from class prior to the 15th of the month. NO EXCEPTIONS!
*
- Tuition remains the same each month regardless of whether it is a 5-week month or a shortened month due to holidays. Tuition is not pro-rated, refunded, or credited for missed classes or holidays. Any student who misses a class may make up classes in other non-performance classes that are comparable for their age/skill level.
*
- If your child is absent due to any reason: illness, vacation, or other activities, payment is STILL due by the 15th to continue to hold the spot in class for your child. There are NO REFUNDS for missed classes.
*
- If your child is no longer taking classes, a “drop” form must be completed or notification in writing is required before the start of the next month. Any outstanding fees on the account must be paid in full upon un-enrollment. Failure to turn in a “Drop” form will result in continued tuition charges and late fees until we receive a completed form or letter.
*
- A $25 returned-check fee will be added on all insufficient funds checks.
*
- If you are not available to pay in person, please either call the studio for payment over the phone or mail your tuition to avoid late fees.
*
- We offer Autobill (automatic credit card deductions) for monthly tuition. We except VISA, MASTER CARD, AMERICAN EXPRESS, and DISCOVER. A Credit Card Authorization Form will need to be completed and signed to take advantage of this automatic deduction. Autobill will run on the 15th of the month, unless the 15th falls on a day that the studio is closed, at which time it will run the next day the studio is open. (THERE IS NO ADDITIONAL FEE FOR THIS SERVICE).
*
- If parents are splitting payment for their dancer(s), written or spoken consent must be given from BOTH parents as to whom is paying what portion of the charges. Any charges that will affect payment must be approved by both parties, who must each inform our Office Manager of such changes. It is the responsibility of the parents to figure out payment plans and not that of the A&G Dance Academy.
*
- All accounts must be completely paid off by May 15th for dancers to be able to participate in the end-of-the-year recital.
*
- If you decide to take time off, the re-enrollment fee within the season is $15.
- PHOTO RELEASE: By checking here, I give permission for photographs of my child in dance class or performances to be used in promotional materials for A&G Dance Academy in both print and web publications. I agree that my child’s picture or likeness can be represented and published in any A & G dance Academy publication. I understand that the photographs of activities conducted by A&G Dance Academy may be used on A&G Dance Academy website or in Brochures or performance programs. Photos will not be used in any other context not related to A&G Dance Academy.

Contact Info

9720 16th St.
North St. Petersburg, Fl 33716

Phone: (727) 826-0799

Email: info@aandgdanceacademy.com

Hours of Operation

Monday – Thursday : 9:00 am – 12:00 pm // 3:00 pm – 9:45 pm

Friday: 3:00 pm – 9:30pm

Saturday: 9:00 am – 3:00 pm

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