Adult/Teen Open Class Registration

Student Information

Please complete a registration form for each student.

Student's Name *

First Name Last Name

Gender *

Male Female

Birth Date *

Month Day Year

Cell Number

Area Code Phone Number

E-mail

Mailing Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Emergency Contact Information

First Emergency Contact's Name *

First Name Last Name

Relationship *

Phone Number *

Area Code Phone Number

School Policies

Please click here to read the 'Gutafson Dance Policies' before agreeing to the terms.

Policy Agreement

Classes are $20 for a single class and $150 for a 10-class card or $200 for a 15-class card. Payment is to be made prior to the start of each class. If using a card, the card is kept in a file box at the front desk. Upon entering the studio, the student should sign in, remove the class card from the file box, date and initial the card, and then leave it out on the desk. The desk person or instructor will re-file the card. Class cards should be used in two months and will expire after two months of absence.

There is no specific required uniform for teens and adults taking open classes, however, it is best to wear dance attire or fitted athletic wear.

All students must wear ballet shoes in ballet classes, and long hair must be secured. We prefer that dancers do not take class in socks or to be barefoot. If the choreography requires being barefoot, please be sure to wash feet well afterward and keep all open sores or cuts covered by band-aids or medical tape (A good practice for all the time.). If you are asked to wear socks, please be aware that the floor can feel slick or become slick with the use of socks. We ask that you consider your own safety and the safety of others in the class over the request to wear socks or dance barefoot. We have slip no more that can be spot mopped in between full studio mopping that is done weekly.

Please keep personal hygiene in mind; using deodorant and wearing fresh clothes makes the class pleasant for all.

It is not appropriate or safe to leave children unattended in the lobby or studio while the parent is taking class.

All cell phones must be turned off while in class.

All teens must be picked up promptly at the end of class.

If you are in a class above your level, please be respectful of the other dancers and stay in the back.

There are no refunds for class cards, due to any reason.

Initials For School Policies *

I have read the School Policies and I agree *

Agree

Media Release

I give permission for photographs or video footage which includes my child to be used for the school's promotional purposes on television, newspapers, magazines, or any other media publications.

Liability/Medical Release

On behalf of my child I agree that Gustafson Dance/State Street Ballet and faculty shall not be liable in any way for any injuries sustained, illness or loss of property during attendance in our programs. Permission is granted for immediate medical treatment and transport for my child in case of an emergency.

Confirmation

I ACKNOWLEDGE THAT I HAVE READ, UNDERSTAND AND AGREE TO COMPLY WITH ALL THE ABOVE RELEASES AND THE POLICIES AND PROCEDURES OF GUSTAFSON DANCE / STATE STREET BALLET.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

YOU WILL RECEIVE A CONFIRMATION EMAIL ONCE REGISTRATION IS COMPLETE.

Signature *