CLASS REGISTRATION FORM

Student Name D.O.B/Grade Street Address Home Phone Mothers Mobile Fathers Mobile Work Phone Email Address How did you hear about Integral Ballet? What month/year did you begin at Integral? Semester/Year Class Description Day and Time
Tuition is based on yearly enrollment, September through June and summer enrollment, July and August. th Students may not withdraw from classes after November 15 and you are responsible for tuition for the remainder of the school year. Your yearly tuition is payable in monthly installments September through June, due on or before the first class of each month. Any payments received after the 10th of the month are subject to a $10 late fee. A paper bill will be mailed to any accounts with an outstanding balance as of the 10th of the month. All tuition paid in full at registration receives a 10% discount. Tuition is structured for the school year calendar: holidays, closures and absences have been considered. Parent/Guardian signature is required on registration forms for any student under the age of 18. There is a $20.00 Service Charge for all checks returned unpaid by the Bank. Please note that our 1.5hour, 1hour and 45minute classes are charged the same as our hourly rate. No refunds after October 15th. Thirty days notice is required to terminate enrollment. A costume deposit of $50 per costume is due at registration. The remaining costume balance will be between $25 and $50 per costume and will be due on or before November 15th. Students must purchase their own tights and shoes in advance of dress rehearsal and picture day. Failure to comply with dress code and costume requirements could result in exclusion from dress rehearsal, picture day and recital. For childrens dance classes, a recital participation fee of $20 is due at registration and includes 1 free ticket to the recital in May. I have read and agree to the terms above. X_________________________________________ Dance Class Attire and Shoes: Ballet (no exceptions): Black leotard and Pink tights for CM, Level 1 and 2 Black leotard and either Pink or Black stirrup tights, Level 3, Red Ballet Belts required Chiffon dance skirts permitted, hair in a bun, ballet slippers (labeled with students name) Other Dance Classes: Tightly fitting black leotard and tan tights, hair pulled back Yoga: Comfortable clothing, bare feet

(Be sure to complete in order to receive your 5 and 10 year awards)

www.integralballet.com 1842 Merrick Rd, Merrick NY 11566 516-442-1590

Recital and Costumes: Dancers performing in our yearly recital and other productions are required to purchase the appropriate costumes through Integral Movement Arts. Costumes may require minimal sewing and alteration. Final costume payment is due by November 15th. Costume deposits and final payments are non-refundable. There will be a dress rehearsal for recital in the spring. Dates are to be determined during the school year. Students are not required to participate in the yearly recital as Integral Movement Arts is not a recital-based school. Rules and Policies: Trial classes are $15 Monthly tuition payments due at the 1st of each month per terms outlined previously Integral Movement Arts reserves the right to drop registrant from enrollment due to nonpayment, disruptive behavior, excessive absences, improper attire Classes with three or less students are subject to shortening Class and level placement is at the discretion of Integral Movement Arts staff No gum chewing, food or street shoes are permitted in the studio Early childhood students must be toilet-trained Family and friends are not permitted in studio unless invited and announced Students must wait inside the building while waiting for parents to pick up All students must remain for the entirety of the recital Please bring your own mat for yoga and Pilates

See your current schedule for a list of studio closings. Refer to current tuition schedule for pricing. Pricing is subject to change. Integral Movement Arts generally follows the Bellmore-Merrick Central High School District for closings. Closings are also announced on the website and Facebook page. Students and parents should call 631-645-3708 for closing information.

I have read, understood and am in agreement with all of the information contained in this form and give my child, who is in good health, permission to participate in dance and movement classes at Integral Ballet. I authorize Integral Ballet to publish photographs taken of me or my child for publicity purposes. Neither the child, nor I, will receive compensation for published photographs. I agree to the tuition payment terms listed above and am responsible for payment (all accounts must be paid in full by May 1st). I hold Integral Ballet, its teachers, staff and school, harmless for any and all injuries arising out of participation in any class(es) or other related activities away from the school. In such event, I further agree that the cost of such medical services shall be borne exclusively by myself. I hereby authorize Integral Ballet to take any necessary steps to make medical attention available, including physicians, hospitals or any other medical services, and Integral Ballet shall have full discretion to make such a decision. Photographs and videos of students from the school may be used for publicity in the future. I have listed below any and all medical problems concerning the student. Student

Print Name of Parent/Guardian Signature of Parent/Guardian Date

www.integralballet.com 1842 Merrick Rd, Merrick NY 11566 516-442-1590