class registration

Thank you for your interest in Premier Dance Performing Arts Center. If you have any questions about our registration process, please feel free to contact us. We look forward to being your dance studio home.

 

Student: First name:*   Last name: *

Date of Birth: *  Age: *

Address:*  Town/City:*  Zip:

Home phone:*  Cell phone: * 

E-mail address:*

Mothers Name: *    Work phone: *

Fathers Name:*    Work Phone: *

Emergency Name:    Phone: * 

* = required information

How did you hear about us?
Friend
Newspaper
Website
Other: Please specify

Please refer to the class schedule below to select dance classes.

Monday
9:30 - 10:00 Baby Ballerinas -
10:00 - 10:45 Rockin Tots I -
10:45 - 11:15 Toddler Tumble -
4:30 - 5:15 Rocking Tots I -
5:00 - 5:45 Dancing Dolls I -
5:15 - 6:00 Ballet I -
5:15 - 6:00 Stretch & Strengthen -
5:45 - 6:45 Dance Sensations -
6:00 - 7:00 Ballet II -
6:00 - 6:45 Jazz & Lyrical I -
6:45 - 7:15 Tap I -
7:00 - 7:45 Tap II -
7:00 - 8:00 Ballet III -
8:15 - 9:00 Jazz & Contemporary III -
Tuesday
11:15 - 12:00 Rockin Tots II -
12:00 - 12:30 Creative Movement -
5:00 - 5:45 Rockin Tots II -
5:00 - 5:45 Hip-Hop I -
5:15 - 6:00 Dancing Dolls II -
5:45 - 6:30 Hip-Hop II -
5:45 - 6:30 Tumble-N-Groove -
6:00 - 6::45 Tap III -
6:30 - 9:00 Comp Choreography -
6:30 - 7:15 Jazz & Contempoary II -
6:45 - 7:30 Hip-Hop III -
Wednesday
5:00 - 6:00 PDCT Ballet leve II -
5:00 - 6:00 PDCT Ballet Level I -
5:00 - 5:30 Stretch & Strengthen -
5:30 - 6:00 Jumps & Turns -
6:00 - 7:00 PDCT Ballet level III -
6:00 - 6:30 Jumps & Turns -
6:00 - 6:45 Jumps & Turns -
6:30 - 7:15 PDCT Tap I -
6:45 - 7:30 PDCT Jazz & Contemporary -
7:00 - 7:45 Pointe -
Thursday
5:15 - 5:45 Stretch & Strengthen -
5:45 - 6:30 Jumps/Turns -
5:45 - 6:45 Pre-Comp Choreography -
6:30 - 7:15 PDCT Tap II and III -
Saturday
8:45 - 9:30 Tumbling I -
9:00 - 9:30 Stretch & Strengthen -
9:30 - 10:15 Tumbling II -
9:45 - 10:15 Sretch & Strengthen -
10:15 - 11:15 Tumbling III -
10:15 - 11:00 PDCT Jazz/Contemporary I -

 

 

By checking this box, I give my permission for Jaye Cummings, studio owner or a studio parent to take my child to a medical/dental facility, if necessary. In case of emergency, If none of the above can be contacted, I herby give my consent for emergency medical care to be adminstered by a duly licenesed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependant. I accept full responsibility for the cost of any said medical/dental care and emergency treatments. Premier Dance Performing Arts Center will not be responsible for the cost of any medical care or emergency treatments. I hereby waive all claims whatsoever in connection with such medical treatments.

I agree that if my dependant or I (heretofore know as “we”) engage in any physical exercise, class or activity on the premises or any venue where we participate as representatives of Premier Dance Performing Arts Center, we do so at our own risk. I agree that we are voluntarily participating in activities and use of said facilities, premises (including the parking lot) and designated Premier Dance Center venues. We assume all risk of injury, illness, damage, or loss to us or our property that might result, including, without limitation, any loss or theft of any personal property. I agree tht this consent and assumption of risk statement covers each and every event or activity sponsored by Premier Dance Performing Arts Center. I agree to release and discharge you (and your affiliates, empoyees, agents, representatives, successors and assigns) from any and all claims or cause of action (known or unknown) arising out of your negligence. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waving any right that I may have to bring legal action to assert a claim against you for your negligence.


Parent-Student Release/Consent Terms & Policies
By checking this box, I acknowledge that I have read through and agree to all of the above terms and policies.

I give my permission to publish photographs on the Premier Dance website, brochures, advertisements, and any other
publications.
Yes No


Parent/Guardian name: Date:

NOTE: Filling out and submitting this form will hold a spot for your child in your selected class(es), however their spot will be secured upon receipt of their registration fee which can be mailed to the studio address below.

 

 


Premier Dance Performing Arts Center
1580 Route 9
Clifton Park, NY 12065

Studio Phone: (518) 373-7000
Email: premierdanceny@gmail.com

 

Website by Studio of Dance.com