Dancer Name *

First Name

Last Name

Parent Name *

First Name

Last Name

Phone *

(###)

###

####

Dancer's Birthday *

MM

DD

YYYY

Dancers under 4 years old:

Is your dancer potty trained? We ask that all dancers use the restroom before class starts to minimize classroom interruptions, but realize that our younger friends might need additional breaks. TINY TUTUS: If dancer's are not fully potty trained, we ask that a parent stays in the lobby to assist with any necessary restroom visits.

Dancer is potty trained.

Dancer is not potty trained.

CLASS SELECTION *

Our Baby Ballet Program is broken down into two options - SOLD OUT: Baby Ballet (Ages 2–3) Tuesdays 10/14 - 12/9 | 4:00–4:30 PM | Through imaginative play, music, and gentle movement, we’ll explore balance, rhythm, coordination, and most importantly - a love for dance. At the end of the session, we’ll celebrate with a relaxed in-studio performance for family and friends - a joyful moment to showcase all they’ve learned. Tiny Tutus “Dance with Me” (Ages 18 mo.–2.5 yrs.) Mondays 10/13 - 12/8 | 4:00-4:30pm - Share the joy of dance with your little one! This playful class invites moms (or any caregiver) to join their dancer for 30 minutes of music, movement, and bonding. Inspired by our beloved Baby Ballet program, Mommy & Me Dance introduces balance, rhythm, and coordination through imaginative games and gentle exercises you’ll enjoy together.

Tiny Tutus “Dance with Me” (Ages 18 mo.–2.5 yrs.) Mondays 10/13 - 12/8 | 4:00-4:30pm

TUITION PREFERENCES *

Tuition and class passes may be purchased on the website Class Pass page, through a QuickBooks invoice sent to the email address provided on this form or by visiting the front desk.

I prefer to purchase tuition online

I prefer to have a QuickBooks invoice sent to the email address provided

MEDIA RELEASE : I, (Parent/Guardian), grant my permission for The Pointe Performing Arts Center to use the name, likeness, image, voice, and/or appearance of My Child (Minor), in any video or images, and the like taken or made on behalf of The Pointe Performing Arts Center. I agree that The Pointe Performing Arts Center has complete ownership of such content, etc., including the entire copyright, and may use them for any purpose consistent with the mission of the Studio. These uses include, but are not limited to posts on social media, rehearsal videos, publications, advertisements, and any promotional or educational materials in any medium now known or later developed. I hereby release The Pointe Performing Arts Center and its agents from any and all claims which arise out of or are in any way connected with such use. LIABILITY RELEASE: Parents, legal guardians of minor students, and adult students waive the right to any legal action for any bodily injury or property damage sustained on studio property resulting from any activity before, during or after dance class or rehearsal. This also applies to family members and friends who are on studio property for any reason. The Pointe Performing Arts Center, Owner/Director, Penny Capps, teachers, teaching assistants and staff are not to be held responsible for any injuries or loss of property sustained on studio property. In submitting this form, I agree to the terms above and have both read and understand the liability release as stated and agree to abide by the terms of the statement. *

Digital Signature of Parent/Guardian

First Name

Last Name

Student/Minor's Name *

First Name

Last Name

Date *

MM

DD

YYYY

*

I have read and understood this consent and release. I give my consent to The Pointe Performing Arts Center for the aforementioned purposes.