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Fall  2010 Registration Form

Student’s Name___________________________________ Today's Date___________

Age as of Sept.____Grade as of Sept. _____DOB____ E-mail_______________________
 
Mother _____________________Father______________________Do you sew? Y  N

Address___________________________Phone___________Cell________________

Sibling discount:  10% off of the lowest tuition. 1st child is regular price.   Each child needs own reg. form. 

(Add $30 for each class that is 1 hr & 15 minutes in length)
Length of Class            Cost/per class      Hours/session          Tuition based on 12 weeks
One 1 hr class                    $15.00                  12                                            $180
Two 1 hr. classes              $14.50                  24                                            $348
Three 1 hour classes        $13.00                  36                                            $468
Four 1 hour classes          $11.00                  48                                            $528
TOPC 1 & 2, Tuition Fee ONLY:  $399.00 (not part of the above fee schedule)

Class 1 ________________ Day_____________ Time_____________

Class 2 ________________ Day_____________ Time_____________

Class 3 ________________ Day_____________ Time_____________

Class 4 ________________ Day_____________ Time_____________

Subtotal                                                                                                         $ ________
Less sibling discount  (10% off  the lesser Tuition only)                     $ ________
Annual Registration Fee   ($15 per family)                                             $                     
Rental Costume Fee $35 (BALLET ONLY)                                           $________

Enclosed is my Deposit ($50 per class )   $________  Check #________    

Final balance due September 1, 2010  (late fee:  $20) Payment plans can be arranged by calling 215-357-7402. 

Checks payable to:   BCDTA    Mail to:  BCDTA  PO BOX 5357 Clinton NJ  08809   (please do not bring to the studio)

There are NO REFUNDS on paid tuition or costumes Should your child decide to drop out during the course of the session, any remaining tuition balance is still your responsibility.  

I agree to hold BC Discover Dance & Theater Arts Company (AKA/BCDTA), the BCDTA instructors & The Brookside Barn Association HARMLESS for any accident, injury or incident that may cause harm to my child or family member.  This applies to ALL SESSIONS that my child or family member participates as well as all locations that activities or instruction take place.  BCDTA has the right to use photographs & recording for classroom &/or promotional use.

_________________________               _________________________________    ___________
           Parent's Signature                                                   Student's Signature                               Date

UNDER CONSTRUCTION , DO NOT INCLUDE WITH YOUR REGISTRATION FORM