Participant's Name *

First Name

Last Name

Birthday *

MM

DD

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Registering for Class: *

Dance With Me! (age 2-4, child/caregiver class): Mondays 10:00-10:45

Homeschool Ballet (age 7-12): Mondays 10:45-11:45

Family Yoga (all ages): Mondays 11:45-1:00

Tuition: Please select your preferred method for tuition payment: *

Invoices will be sent to the email address provided on this registration form

Full School Year (includes 10% discount)

Per Semester (2 equal payments)

Per Quarter (4 equal payments)

Bi-Monthly (5 equal payments)

Monthly (8 equal payments)

Drop In ($35/class)

Homeschool 10-Class Package

Tuition Discounts: Please check all that apply

Full Tuition Discount: 10% off tuition paid in full for the school year

Multi Class Discount: 5% off multiple class purchases

Dance With Me Sibling: 20% off a participating sibling in KDA"s Dance With Me class

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent 1 *

First Name

Last Name

Parent 1 Cell Phone *

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Parent 1 Work Phone

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Parent 2

First Name

Last Name

Parent 2 Cell Phone

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Parent 2 Work Phone

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Emergency Contact Phone *

(###)

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Healthcare Provider Contact Number *

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KDA Studio Policies *

By checking this box, I am electronically signing that I have read, understand, and agree to the terms and policies established by Kailua Dance Academy

Please Note: Tuition pays for a child's place in class, and a registration form alone cannot guarantee a spot in class. *

I understand.

Missed Class: Tuition pays for a child's place in class, and is not refundable in the event of a missed class. *

I understand.

KDA Liability Waiver and Talent Release *

By checking this box, I am electronically signing that I have, read, understand, and agree to Kailua Dance Academy's LIABILITY WAIVER AND TALENT RELEASE

KDA Tuition Policies *

By checking this box, I am electronically signing that I have read, understand, and agree to Kailua Dance Academy's policies regarding TUITION AND PAYMENTS.