THE DANCER BY GINA FALL REGISTRATION 2020-21
*Complete all information and return with Covid waiver to: The Dancer By Gina, PO Box 252, Delphos, Ohio 45833.
*Please use one application per dancer! Questions... call 419-692-6809 or check us out at thedancerbygina.com!
*Applications must include first month (Sept.) tuition and registration fee.
Registration fee $25/individual, or $35/family. *If received by August 10, 2020 deduct $10 for early discount.
STUDENT’S NAME___________________________ AGE_____ (Please circle) Girl / Boy
BIRTH DATE______________________ GRADE (Fall 2020)________________
ADDRESS___________________________________
C ITY__________________ STATE_________ZIP_____________ Please check if new info
Person responsible for bill______________________ Phone for billing________________
PARENTS NAME__________________________________ Email_______________________
Phone_______________________
Years of dance experience completed at DBG_________/ # of years elsewhere ______________________
Ballet___, Tap___, Jazz___, Clog___, Modern___, HipHop___, Pointe__ (Write in years completed per genre.)
_____Yes I am a 5,10,15 year trophy recipient at the end of this dance year. Please circle year.
_____Yes, I am a 5,10,15 year trophy accumulative dancer at the end of this dance year. Please circle year.
DBG will purchase trophy for years with DBG and parent purchases trophy for accumulative.
PERSON TO CALL IF PARENTS CANNOT BE REACHED___________________________Phone_____________________
Relationship___________________
NAMES OF SIBLINGS ENROLLED-______________________________________________
HOW DID YOU HEAR ABOUT US?__________________________________________________________________________
CLASSES I WISH TO ENROLL IN- (Descriptions and pricing on next page. No refunds/credits on tuition fees or classes. These are the classes you will take in September. Adding, dropping, or changing classes require the appropriate form filled out for the following month classes. Payment may be made for entire year or divided into nine monthly payments Sept 1, 2020 through May 1, 2021.
Mommy and Me/ Daddy and Me_____ (ages 18 months- 3yrs.) 10 week sessions (Fall/ Winter/ Spring)
Combination dance class 45 min. (ages 3-5)_____, Advanced Combination 45 min. (Grades K-2)___,
Cheer dance 45 min.(K-6)___,
Grades 2-5 Ballet 30 min ___, Tap 30 min___, Jazz 30 min___
Grades 6-12 Ballet 45 min____, Tap 45 min_____, Jazz 45 min_____
NEW Beginner HipHop 30min. (Ages 4-7)_____
HipHop 45 min. (grades 2-4)____, (grades 5-7)____, (grades 8 -12)___ , Boys HipHop (45 min) ______
Contemporary/Modern 45 min. (grades 2-4)____, (grades 5-7)____, (grades 8-12)____
Clog 45 min. (grades 2-4)____, (grades 4-6)____, (grades 7-12)_____
Barre technique_____ ( All competition dancers must be enrolled in barre, as well as pointe dancers.
Beginner Pointe (must have had prior ballet training) ages 11 and up____, Pointe II (Int/Adv.)______
Tumbling____ (Please circle- Early Beg./Beginner/ Adv. Beg. / Intermediate / Advanced) 10 week sessions
Ballet_____, Tap_____, Jazz_____, Clog_____, M
All students and their parents/ legal guardians are aware of possible physical injury that may occur during dance/ tumbling classes, performances, and/or rehearsals and are willing to assume those risks. It is agreed that students, and their parents/ legal guardians will not hold The Dancer By Gina , its director, and/or faculty and staff liable for injuries sustained while in attendance or while participating in any Dancer By Gina activity or event. I also give permission to use photo or videotape material taken at DBG events for studio advertisement, promotions, and /or media releases.
I,____________________________, parent/guardian of ________________________, have read the above statement and also The Dancer By Gina studio policy form and fully understand its’ contents. Date____________
Office use only- Registration Amt. Pd. _________ Tuition Amt. Pd. ________ Date______________
Dance concert tickets Pd. ______ Check #___________ Cash_________ Received by___________
FOR IMMEDIATE RELEASE BALLROOM DANCER ENTHUSIAST CELEBRATES! SPINAL
GRAND VALLEY’S DANCE MARATHON 2009 DANCER REGISTRATION PACKET DEAR
INTERNATIONAL ORGANIZATION FOR THE TRANSITION OF PROFESSIONAL DANCERS TOOLKIT
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