2015 Printable Registration Form

SCHOOL YEAR PROGRAM
2015/2016
 All students are required to pay a $20/student
($30/family) non-refundable Registration Fee.
 Tuition may be paid for the full year or in
monthly installments. Each class receives 37
lessons during the year. June’s Tuition is ¼
the amount of regular monthly tuition & will be
due with May’s tuition.
 Monthly fees are the same whether there are
3 lessons or 5 lessons in a month, as tuition
costs have been divided equally over all
lessons.
 Tuition is due on the 1st of each month. A
Late Fee of $7.00 will be charged if
payment is not received before the 15th of
each month. All fees are on a per student
basis.
COSTUME FEES
 Costumes for the December, March and June
dance recitals are ordered and purchased in
October, therefore all costume deposits are
due before October 1, 2015.
 All classes except Classical Ballet,
Breakdance & Cheer/Tumbling have a
$125.00 Costume Deposit. Most classes
will receive two costumes for this price.
 Classical Ballet, Cheer/Tumbling &
Breakdance have a $75.00 Costume
Deposit as they need one costume for the
June recital.
 Performance Teams costumes are handled
separately through team contracts.
 If the costumes cost less than expected,
credit will be applied to Tuition. If the
costumes cost more than deposit, you will be
billed for the balance. (We cannot control
Manufacturers’ costs, this deposit is an
estimate based on previous years.)
MEDICAL
AUTHORIZATION
 Correct technique & strict attention to safety
will be the foundation of every class.
Students are expected to follow the safety
rules as detailed by each instructor. Parents
& dancers should note that participation is at
own risk.
 In the event that an injury should occur, I, The
Undersigned, will not hold The Instructor or
Kathryn Howard School of Dance liable. I
authorize Kathryn Howard School of Dance
and its instructor to make emergency medical
decisions in the event that I am not able to be
reached in a timely manner.
X
Signature of Parent/Guardian
You must pay the $20 registration fee
to hold a place in your
preferred classes.
STUDENT
REGISTRATION
TUITION AGREEMENT
Dancer
Age
Birthdate
Parent(s)
Address
Preferred Ph #
Alternate Ph #
Email Address:
Class Title/Day/Instructor
Class Length
Total Hours/Week Enrolled
Registration Fee:
Monthly Tuition:
$
20.00
+$
Costume Deposits: + $
Amount Enclosed = $
KATHRYN HOWARD SCHOOL OF DANCE
2015-2016 TUITION CHART
Hours/Week
Tuition/Month
Hours/Week
Tuition/Month
0.50
0.75
1.0
1.25
1.50
1.75
2.0
2.25
2.50
2.75
3.0
3.25
3.50
3.75
4.0
4.25
4.50
4.75
5.0
5.25
5.50
28.00
38.00
48.00
58.00
68.00
78.00
90.00
100.00
110.00
115.00
115.00
125.00
135.00
140.00
140.00
150.00
150.00
150.00
150.00
150.00
150.00
5.75
6.0
6.25
6.50
6.75
7.0
7.25
7.50
7.75
8.0
8.25
8.50
8.75
9.0
9.25
9.50
9.75
10.0
10.25
10.50
10.75
150.00
150.00
160.00
170.00
170.00
170.00
170.00
170.00
180.00
190.00
200.00
200.00
207.50
215.00
222.50
230.00
237.50
245.00
252.50
260.00
267.50
Sibling Discount:
Deduct $5/mth for each additional student
 I understand that my child’s tuition will be
$
per month and I am
responsible for paying tuition on the 1st of
each month.
 A Late Fee will be charged for tuition not
paid in full before the 15th of each month.
 By signing this agreement, I understand
that I am committed to being enrolled
through the 2015/2016 season. This
agreement begins with my child’s first class
and continues through June 11, 2016.
 The Studio assumes you are continuously
enrolled through the 2015/2016 season &
you will be responsible for tuition unless
The Studio is notified in writing.
 Tuition is charged on a monthly basis,
should a dancer drop any class, the full
month tuition will still be due for that month.
 I understand that I am responsible for a
non-refundable costume deposit, due
before Oct 1, 2015. Costumes not paid
by this date will not be ordered and a
$20.00 charge per costume will be added
to cover manufacturer’s shipping &
handling for separate orders.
 I understand that I will not receive monthly
bills and that I am fully aware of my
financial obligation upon signing this
agreement.
 Returned checks will be charged a $25
NSF fee.
 By signing this contract, I grant permission
to Kathryn Howard School of Dance to use
photographic portraits or pictures of the
minor through any medium at her studio or
elsewhere, and in any and all media now or
hereafter known, for art, advertising trade
or any other purpose whatsoever.
 I have read the entire registration form and
understand its contents.
I agree to
participation as outlined.
X
Signature of Parent/Guardian/Payee
Mail this form & payment to:
Kathryn Howard
1055 Big Bend Road
Roseburg, OR 97471
Studio: (541) 672-8811
STUDIO LOCATION:
(BEHIND KEN’S DRYCLEANING)
1437 NE DEE ST, ROSEBURG,
OR 97470
WWW.ROSEBURGDANCE.COM