Student Name
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First Name
Last Name
Parent Name
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First Name
Last Name
Parent's Email Address
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Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Cell Phone
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(###)
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Phone #2
(###)
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Gender
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Date of Birth (xx/xx/xxxx)
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Student Age
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How Did You Hear About Pacific Dance?
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If "Other " please state where you heard about Pacific Dance
School Policies
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REGISTRATION
A registration form/waiver must be completed and submitted from our website by the parent or legal guardian before any class is taken.
There is a $35 registration fee. If you discontinue classes for any reason for more than one month and then return, you will be required to pay the registration fee upon re-enrolling.
TUITION/FEES
Tuition for classes is a monthly tuition (regardless of the number of weeks or holidays in any month). Please see Holidays Closed on our website.
All tuition must be set up for Auto Pay with a credit card. Your credit card will be charged on or about the 1st day of each month. Should your card be declined for any reason, you must pay by the 7th day of the month to avoid a $35 late fee and provide us with your new credit card information by the 7th day of the month in which it was declined.
NO statements will be sent to you unless your tuition is late. A $35 late fee will be charged for all tuition payments received after the 1st day of the month.
A $35 fee will be charged on all returned checks.
NO credit or refund is given for absences, tuition, costumes, competition fees, workshop fees, or convention fees.
If you are dropping any or all classes, you must notify us via e-mail at PacificDance1@gmail.com by the 20th day of the month preceding the month you would like to drop, or you will be responsible for paying your tuition for the following month.
ABSENCES
If you are absent from a class, you may request a courtesy make-up in a comparable class after the class is missed. A make-up must be taken no later than one month from the date of the absence, and you must be currently registered in a class. Once you drop all classes, you lose all make-ups. Make-ups are non-transferrable. All make-ups must be requested at least 48 hours in advance of the class you are interested in making up in from our website Make-Up page. Pacific Dance will send a confirmation email. Not all classes will be open for make-ups. Pacific Dance has the right to refuse the use of a make-up should the class size be too large on the day of a make-up, or if the level/age is not appropriate for the student.
If you are taking a make-up class in a 90 minute class and are not enrolled in a 90 minute class, you will need to use two make-ups to take a make-up in a 90 minute class.
We cannot guarantee a make-up will be available for your schedule, age or level.
ATTIRE
Proper dancewear and shoes are required for all classes (please see the Required Dance Attire page on our website for details).
RECITAL
Our annual Recital is optional. If you decide to participate in the Recital, you are required to have good attendance in your class(es), purchase the assigned costume(s), tights and shoes, and attend mandatory rehearsals and all scheduled recital performances.
If your account balance is not paid in full prior to the Mandatory Dress Rehearsal date for the Recital, your child will not be able to participate in the Recital.
SUPERVISION OF STUDENTS
Children are supervised during class time only and should not be dropped off early or picked up late.
PHOTOGRAPHY AND VIDEOTAPING
Unless prior parental and teacher authorization has been given, no photography or videotaping is allowed at Pacific Dance of any student other than your own.
MISCELLANEOUS
Despite our safety precautions, there is a risk of contagion in any public place. By coming into the studio, you are acknowledging that you understand these risks and do not hold Pacific Dance or employees liable.
Due to the uncertainty of the pandemic, Pacific Dance could be closed by the State of California, County of Orange or City of Irvine at any time for safety. In this case, there are no tuition refunds or cancellations.
In order to maintain the quality level of dance training at Pacific Dance, classes run year-round. Very often our classes are full, so space may be limited. If you drop your class(es), your space in that class cannot be held. If you have any questions, please feel free to e-mail us at PacificDance1@gmail.com
WAIVER/RELEASE FROM LIABILITY & TUITION AUTOPAY
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I have chosen to have my child participate in dance instruction given by Pacific Dance, Inc. (“Pacific Dance”). I acknowledge that I understand the nature of the activities my child will be participating in and that my child is in the proper physical condition and capable of participating in the related activities, understanding that Pacific Dance is not in any way responsible for making such a determination. In consideration of my child’s enrollment in any dance instruction program, I understand and agree on behalf of myself and my child, to release, hold harmless, and discharge Pacific Dance from all claims, costs, liabilities, expenses or judgments, including attorneys’ fees and court costs for any occurrences in connection with any dance instruction. I assume all risks to my child in connection with any instruction and further release Pacific Dance and its owners and employees from liability for any injury sustained by my child while he or she is enrolled in any dance instruction program, including all risks reasonably connected with such activity whether foreseen or unforeseen. I understand that despite precautions and policies put in place by Pacific Dance, there is a risk of any contagion, including Covid-19, to my minor child or myself. Participation is voluntary with knowledge of this risk. By executing this Waiver, you hereby release Pacific Dance from any and all liability and responsibility that may arise from any infection by, or exposure or suspected exposure to, the Coronavirus in connection with dance classes. I understand that Pacific Dance is not responsible for my child or other children under my supervision who are left unsupervised in the common areas and areas surrounding the dance studio and that Pacific Dance will only be supervising my child when he or she is participating in scheduled dance activities, programs or instruction. I understand that Pacific Dance is not responsible for personal property that is lost, damaged or stolen while I or my child is at or on Pacific Dance property. I acknowledge and agree that it is my responsibility to maintain my own accident and health insurance coverage that provides adequate coverage for myself and my child participating in Pacific Dance activities and that Pacific Dance does not provide accident or health insurance for those participating in its instruction, activities or programs. I authorize and agree that Pacific Dance may take and use photographs, videos or likenesses of myself or my child as needed for its record-keeping, advertising and/or public relations projects and that I have no rights to the same and will not be compensated for the same. By clicking the "I Agree" box I agree to execute a complete and unconditional waiver and release of all liability pursuant to the terms herein, and agreement as to all terms and conditions contained above. I am of lawful age and competent to execute this affirmation. I HAVE FULLY INFORMED MYSELF AS TO THE CONTENTS OF THIS RELEASE AND HAVE READ THE SAME PRIOR TO AGREEMENT OF TERMS.
TUITION AUTOPAY
I understand and agree that Pacific Dance will charge my credit card provided by me in the amount of my current tuition on or about the 1st day of each month.
I understand and agree that this charge is for monthly tuition, and the recurring charge will continue for 180 months or until I have provided Pacific Dance notice via e-mail at PacificDance1@gmail.com to drop all of my classes and terminate my recurring charge. This e-mail must be sent by the 20th day of the month preceding the month you want to drop all classes.
I understand and agree that if my credit card is declined for any reason whatsoever (i.e., it has been declined, cancelled or changed), my account will be manually invoiced and will incur a late fee of $35 if my account has not been paid manually via check, cash or credit card prior to the 7th day of the month. It is my responsibility to contact you with my updated credit card information.
I will not dispute Pacific Dance’s recurring billing with my credit card issuer so long as the amount in question was for services rendered prior to my canceling my account in the manner required.
I guarantee and warrant that I am the legal cardholder for this credit card and that I am legally authorized to enter into this one time or recurring billing agreement with Pacific Dance.
