Chassé Center of Dance Registration Form
Register your family for dance classes for the 2020-2021 dance season.

Please fill out all the information for Child #1 below. If you only have one child, you can skip Child #2-4 and continue at the Parent/Guardian information section.

Once you submit your form, Ms. Butler will reach out to you to complete the payment process.

Please contact 704-565-9484 for questions
  • Please adhere to the age groups. If you do not select the proper age group, we at Chassé Center of Dance have the right to change your child to the appropriate group. Please Note: Chassé also has the right to move a child's class based on maturity and ability.
  • Please adhere to the age groups. If you do not select the proper age group, we at Chassé Center of Dance have the right to change your child to the appropriate group. Please Note: Chassé also has the right to move a child's class based on maturity and ability.
  • Please adhere to the age groups. If you do not select the proper age group, we at Chassé Center of Dance have the right to change your child to the appropriate group. Please Note: Chassé also has the right to move a child's class based on maturity and ability.
  • Please adhere to the age groups. If you do not select the proper age group, we at Chassé Center of Dance have the right to change your child to the appropriate group. Please Note: Chassé also has the right to move a child's class based on maturity and ability.
  • Guardian Information

    Please enter parent or legal guardian information here
  • - -
  • - -
  • - -
  • - -
  • WAIVER OF LIABILITY

    I, _______________________________________________, HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH ATTENDING ANY AND ALL CHASSÉ CENTER OF DANCE LLC EVENTS, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of Chassé Center of Dance LLC and/or their directors, officers, employees, volunteers, representatives, agents, the activity holders, sponsors, and volunteers. And from dangerous or defective equipment or property owned, maintained, or controlled by Chassé Center of Dance LLC and/or their directors, officers, employees, volunteers, representatives, agents, the activity holders, sponsors, and volunteers, or because of their possible liability without fault.

    I certify that I am physically fit, have sufficiently prepared or trained for participation in this activity, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems which preclude my participation in this activity. I acknowledge that this Accident Waiver and Release of Liability Form will be used by Chassé Center of Dance LLC sponsors, and organizers of the activity in which I may participate, and that it will govern my actions and responsibilities at said activity. In consideration of my application and permitting me to participate in this activity, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

    I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: Chassé Center of Dance LLC and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers;

    INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that Chassé Center of Dance LLC and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this activity may involve a test of a person's physical and mental limits and carries with it the potential for death, serious injury, and property loss. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, volunteers, monitors, and/or producers of the activity. These risks are not only inherent to participants, but are also present for volunteers. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this activity.

    I understand while participating in this activity, I may be photographed. The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

    I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.
  • MEDICAL RELEASE

    I, ______________ (parent/guardian) hereby give permission for any and all medical attention to be administered to my child(ren) (SEE ABOVE) in the event of accident, injury, sickness, etc., under the direction of the physician listed below or at any necessary emergency facility, including transportation, until such time as I may be contacted. I also assume the responsibility for the payment of any such treatment. This release is effective for a period of one year from the date of this application.
  • - -
  • PHOTO/VIDEO RELEASE
    I give full rights to Chassé Center of Dance LLC and its staff to use photos and video images of me or my child to use for promotional purposes of Chassé Center of Dance LLC only. Photos and videos will be used in brochures, websites, advertisements, social media and other promotional material created by the studio. Photos may appear with or without names in press releases and other print advertising.
  • Chassé Center of Dance LLC
    CODE OF CONDUCT

    Registration (Non-Refundable)- A $45.00/dancer, $85/family of two, (+$10 for each additional family member) annual registration fee is required with the application form to reserve class space. Registration is not considered complete until this fee is paid.

    Tuition (Non-Refundable)- Tuition is due by the 1st of each month. A $15.00 late fee will be applied to any tuition paid after the 5th day of the month. For any account that is not current, the student will be asked to sit and observe the class until the account is current. Any unpaid fees that extend beyond a 30-day period will receive an additional $15 late fee. Balances extending beyond a 60-day period will be turned over to small claims and your dance account will be terminated. If a student is absent, it does not change the due date of a payment or the total amount due per month (we do not prorate). Note: Tuition prices have changed effective August 1st, 2019.

    Cancellation/Withdrawal Policy- Parents MUST fill out a cancellation statement, in person, by the first of the month. Verbal and electronic statements are not considered valid forms of cancellation. If forms are not completed by the first of the month, you will be charged for the upcoming month. No exceptions. This includes dropping classes and/or leaving the studio. You must have a face to face meeting with Ms. Butler before the first of the month to sign off on cancellation forms. If you wish to return, you must pay a reactivation fee of $35 per child AND your previous remaining balance if applicable. Spots will not be held. Cancellation forms will be available at the front desk.

    Absences/Late Policy- Parents are responsible for reporting dancer’s absences from classes. If students are more than 15 minutes late to class, they may not participate. There will be absolutely no refunds for missed classes. For all absences, please email ChasseCenterofDance@gmail.com at least 24 hours prior to the start of dance class unless reporting an unforeseen emergency. If a student is absent three consecutive classes without notification, via email, they will automatically be withdrawn from the class roster. See cancellation policy above for re-registering.

    Pick-Up Policy- Classes will end 5-10 minutes before the end of the hour. Approved rides must be present 10 minutes prior to the end of class. Parents must wait downstairs to retrieve students from class. Please do not enter classes. There is a $15 late fee +$1 per minute for every fifteen minutes that dancers are picked up after the end of their class time (i.e. 5:18 pm=$18 late fee). Siblings/family members (minors) may not wait around the facility unsupervised. If a student’s dance session is over, they may not wait in the facility while another student finishes classes. Students may also not be dropped off early to wait around unsupervised.

    Dress Code-
    Students MUST be in dress code each class. This includes attire, hair, and shoes.
    STUDENTS MUST BE DRESSED (INCLUDING SHOES) OR THEY WILL NOT BE ALLOWED TO PARTICIPATE FOR THE DAY. THIS IS A STANDARD STUDIO RULE!
    All hair must be pulled back in a ponytail/bun. Long hair must be secured in a bun. We do not provide hair ties
    No jewelry allowed. Students may dress in black, form fitting layers for warm up for the first 10 minutes of class
    Students must come dressed and ready for class. Limited changing (between classes) will be allowed.
    Please pack a WATER BOTTLE each class (NO GATORADE, SODA, OR JUICE)
    BALLET- Girls: Black leotard, pink tights, pink ballet slippers, no skirts. Boys: Black, fitted tank top, black fitted shorts or pants, black ballet slippers.
    JAZZ/LYRICAL/TUMBLING/TAP- Girls: Black leotard, black jazz pants or shorts, black or tan jazz shoes, (tan/pink tights). Boys: Black, fitted tank top, black fitted shorts or pants, black or tan jazz shoes. Lyrical/Tumbling: Bare feet Tap: Black Tap Shoes
    HIP-HOP- Any athletic/dance clothing. Closed-toed, dance appropriate sneakers. NO black bottom soles to avoid floor damage. Ballet attire should be worn under hip-hop clothing for quick changing between classes.

    Class Apparel and Costumes- Students are not to wear their class apparel (shoes included) or costumes any time outside of scheduled events/classes. We want to keep our apparel crisp for performances and cannot guarantee that if students are wearing their apparel outside of class/performance dates.


    Student Behavior- Participants in Chassé Center of Dance LLC classes are expected to exhibit upstanding behavior before, during, and after scheduled classes. Students will be on a three strike system. Should a student receive three infractions, they will not be permitted to attend the following class (no refunds for missed classes). Intervention actions (verbal warnings, timeout, etc.) will be taken prior to student suspension. Electronics are prohibited during classes. Should a student break this rule, electronics will be
    confiscated and returned to the parent/guardian at pickup.

    Parental Support/Expectations- Parents are expected to remain in constant communication with our staff as it pertains to Chassé Center of Dance LLC. Necessary emails/texts will be sent that will need to be read/responded to in a timely manner. We will have mandatory parent meetings on Zoom; dates TBA. Please be sure to follow our Facebook and Instagram as well for updates! Please DO NOT call the studio number during class times. Once classes have begun, we are unable to answer questions or concerns about tuition, schedules, studio directions, etc. This is unfair to the students who are taking the current class if the instructor has to stop and handle these concerns.

    Recital Fees (Non-Refundable): Recital fees will be added into monthly tuition during the month of NOVEMBER and FEBRUARY. This fee is separate from costume fees. These fees are mandatory for all participants. Additional recital information will be presented at parent meetings. If a costume has been ordered, the customer is responsible for the full price of the costume(s) and/or shipping (return) fees.

    Studio Damage and Upkeep Policy: Parents and students are expected to upkeep the studio through conducting upstanding behavior and proper treatment of the facility. Damages to the studio (this includes the dance studio, lobby, bathroom, doors, floors, stairwell and exterior of the building) will be charged to the family account starting at a minimum of $25 + any additional fees based on the damage done (including materials and labor).

    Phone/Electronic Policy: Students may not use electronics during class time or breaks. Phones need to be left with parents or placed in the bin upon entrance of the studio. Phones must be turned off/on silent (not vibrate) and students will only be allowed to retrieve them at the END of their dance session. Teachers have the right to confiscate electronics should this rule be broken and will return directly to parents at dismissal/pick-up. Chassé Center of Dance LLC is not responsible for lost, stolen, cracked or broken electronic devices. If you worry it will be damaged, please leave it in the car!

    Food and Drink Policy: Students must have a full water bottle for each dance session. Other food and drinks are strictly prohibited (this includes Gatorade/Powerade). Damage to the studio by food and/or drinks will fall under our Studio Damage and Upkeep Policy (see above). Please have students eat before they come to class. Sessions are no longer than 3 hours maximum and do not require eating between classes.

    Potty Training: Due to sanitary and privacy concerns, the staff is not responsible for students who are unable to use the bathroom on their own. Parents should assist students with a bathroom trip before class begins to eliminate potential accidents or interruptions to class.
    s
    We reserve the right to change student placement of classes regardless of age. This is on a case-by-case assessment and will be communicated to the parents should we feel the dancer needs to be moved up or down a level.


    Please remember all questions and concerns should be emailed to Chassecenterofdance@gmail.com or text to 704-565-9484 between the hours of 8:00 am- 6:00 pm. Please do not call during scheduled class hours. Please allow 24 hours of response time.
Powered byEMF Form Builder
Report Abuse