Kick Fall 2008 Registration Form
Name:____________________________________ DOB:________
Parents Name:
__________________________________________
Address:
________________________________________________
City: ______________________
Zip Code:___________
Phone:___________ E-mail:_______________________
Which Class (es)
are you registering for? (Please select classes
carefully, transfers may not be available)
Class Fee:
Costume Fee:
Total Due:
Current Payment:
New
Students only – How did you hear about Kick?
Fees
(Rates are per family)
Registration fee........................
$25/family per year
One class/week........................ $225
Two classes/week.................... $395
Three classes/ week................ $550
Four classes/week................... $650
Five classes/week.................... $750
Six classes/week...................... $800
Seven
classes/week................ $850
I understand that dance is an inherently risky
activity and I agree to hold harmless, Kick, Vanessa Berry, and any other
instructor at Kick for any bodily injury sustained while participating in any
class or performance associated with Kick. I also understand that all payments
are final and refunds and make up classes are not offered. Monthly payments are
due by the first of the month. Final Fall payment is due by 10/31/2008. I have
read the Fall 2008 Dance Brochure and I am familiar with the required dress
code for dance classes (do not forget to check with Vanessa BEFORE you purchase shoes!)! Kick has
an open door observation policy; however, parents are strongly encouraged to
limit observation to the last five minutes of class.
Parent/Guardian
Signature: _____________________________________ Date: ___________________
Fair Haven,
NJ 07704 (732) 212-1322
www.kickstudio.com