Classes: Type/Level/Day/Time:  1______________________________  2 _____________________________________

How did you hear about us? __________________________________________________________________________
                                           

Registration secures a space in class. Tuition payable by cash or cheque to Karin Hobby Dance Academy or by credit card including 13% HST. Deposit ($100) and registration fees are non refundable and there may be an administration fee for transferring between classes. Term fees are non refundable once the term has started. Cheques for the initial payment cannot be post-dated. There is a $25 fee for returned cheques. Transfers will only be permitted when space and level of training allows. Please read the handbook for full details. Please do not email your credit card information.

If paying in full:		If paying in 2 instalments:
Full term fees:	$ ________	First Instalment	$ ________	Second	$ _________
Registration fee	$       25.00	Registration Fee	$       25.00	(cheque dated Dec 1)
Subtotal	$ ________	Subtotal	$ ________
Add 13% HST	$ ________	Add 13% HST	$ ________	Add 13% HST	$ _________
Total	$ ________	Total	$ ________	Total	$ _________
Cheque Number	________	Cheque Number	________	Cheque Number	_________

 If paying by credit card indicate    M/C        Visa        

Full name on the credit card _____________________________________________________________________

Number_________________________________________________________ Expiry mo/yr___________________

Signature________________________________________________________ Date __________________________

Waiver Agreement.
I understand that there will be costume fees for  end of year shows. In addition, I have read the student/parent handbook and agree to the conditions outlined therein. I hereby consent to my child being photographed and or videotaped in school performances by photographers assigned by the school. These photographs may be used for KHDANCE promotional displays, advertising and school related functions. I respect that my own photographing of other KHDANCE students is not permitted without their own consent both in class and in performance. Video recording or other   recording of KHDANCE performances are not permitted due to copyright laws. I acknowledge that dance is a physical activity and the potential risk for physical injury does exist. Our goal is to minimise this risk. Acknowledging this, I will not hold KHDANCE, its faculty, staff, volunteers or venues responsible for any injuries which do occur. I understand that failure to abide by the conditions of enrolment may result in discontinuation of studies at KHDANCE and forfeiture of the remainder of paid tuition. I understand that in providing my email contact  I consent to receiving school communications to the address provided. I understand that students are generally not accepted if studying or teaching at other dance schools within the city and non disclosure will constitute a breach of school policy. Any concerns I have will be brought forward to school staff.  Positive feedback is also welcome!

Parent/Guardian Signature________________________________________ Date ______________________________________

Welcome to Karin Hobby Dance Academy ©KHDANCE2017 We look forward to working with you!
Better Ballet