To register, please print this form and mail with payment to:
American Dance Institute 8001 Greenwood Avenue North
Seattle, WA 98103
Pre-Registration Dates:
Summer:
Returning Students, May 12 - 17, 2008
New Students, May 19 - June 6, 2008
Fall:
Returning Students, Aug. 11 -16, 2008
New Students,Aug. 18 - Aug. 28, 2008
Student’s Name:
Parent’s Name (if student is under 18):
Mailing Address:
ZIP:
Email Address:
Phone - Home:
Student's Date of Birth:
Phone - Work:
Emergency Contact:
Phone - Cell:
Emergency phone #:
Check one: Returning Student New Student
If new student, how did you hear about us? ____________________________________________________________________________
Class(es) Wanted (include days and times):
Please describe any physical limitations of student and list
any serious past injuries.
I agree to
participate/let my child participate in the programs of American Dance
Institute, and hereby release American Dance Institute, its owners,
instructors and employees form liability for any injury I/my child may
suffer as a result of my/their participation. I have read & understand the
tuition, refund & missed class policies.
Signature:
Date:
Payment enclosed for (please check one):
Full Semester, Pre-Paid in Full
$
5% Early
Bird Discount for Full Session paid before June 6, 2008
