Trial Class Registration Greenwood ⋆ American Dance Institute

Student's Name*

First Last

Choose your class.*

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Preferred Start Date*

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Age*

Date of Birth*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Is the student OVER or UNDER 18 years of age?*

CHOOSE ONE

Parent #1 Name

First Last

Primary Email*

Enter Email Confirm Email

Note: This is for all school business correspondence and announcements. We will add your email address to our school newsletter. We will not share your email with anyone. You can opt out of the school newsletter at any time.

Primary Phone*

Is this a mobile phone?

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Do we have permission to message you on school related matters?

Please tell us your mobile phone carrier?

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What is your communication preference?*

Which is the fastest and most reliable way to message you with school communications?

Secondary Phone

Emergency Contact Name

Emergency Contact Phone

Please list any physical limitations or serious past injuries. If none, write none.*

Please tell us what dance experience level is. Choose answer that best describes where you are today.*

Please tell us where you have studied dance and how long, if any.

Please tell us why you and/or Your child have chosen this dance class? Check boxes that apply.*

Please explain Other, above?

What do you want out of your class(es)? What is your goal?

Please list all of the reasons why you chose our school?*

How did you learn about American Dance Institute?*

Where have you seen/heard us?

Please explain what 'other' means in how you first learned about us?*

What was your experience using our website?*

CHOOSE ONE

Please describe what you mean that the site was too cluttered?

How might we improve navigation?

We need a little more info to improve navigtion. Would you be kind enought to assist us?

What kind of device were you using When viewing the site?

CHOOSE ONE

Terms of Use*

Yes, I agree to ADI's terms of use
No, I do not agree to ADI's terms of use.

1. I agree to participate/let my child participate in American Dance Institute’s classes and hereby release American Dance Institute, it’s owners, officers, instructors and employees from liability for any injury I/my child may suffer as a result of my/their participation in classes and community events that we participate in. 2. Class size is limited. Tuition (partial or full) must be paid in advance to reserve a spot in any class. If you choose our payment plan, you are liable for the full tuition once we reserve a space for you in class. Because we limit class size, we cannot credit you for missed classes. Make up classes are permitted within the same session. Check with instructor for appropriate make up classes. If a student has to withdraw due to medical reasons, credit towards another quarter will be given with a valid doctor’s note. You will be charged for all classes until ADI is notified of medical circumstances. 3. I hereby authorize American Dance Institute to publish photographs taken of me, and or my child for use in the ADI’s printed publications, promotions and website. 4. I acknowledge that since my participation in publications and websites produced by ADI is voluntary, I will receive no financial compensation. 5. I further agree that my participation in any publication and website produced by ADI confers upon me no rights of ownership whatsoever. I release ADI, its contractors and its employees from liability for any claims by me or any third party in connection with my participation. 6. I agree to write and post a review about this school on one or more aspects that I find appealing and to share that review on Google, Facebook, Yelp or other social media I use.

Please tell us which term you do not accept and why?*

Please give us the opportunity to address your concerns so that we might find a workaround.

Your comments, questions, or special instructions.

Greenwood Trial Class Registration