Registration — Monona Academy of Dance

Medical Conditions (if applicable)

Parent/Guardian 1 Email

Adult students put your email here.

Parent/Guardian 2 Email

Billing Email (if different)

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Questions/Comments

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Statement of Understanding

I hereby acknowledge that I am responsible for payment of all tuition based upon payment option selected below. Failure to meet payment criteria will result in your dancer not being allowed to participate in class. A late fee of $5 will be applied at a bi-weekly rate for each 14 days payment is not made. Credit Card information can be encrypted within Quickbooks for automatic payments to be run on your behalf. Multiple late payments will result in this being the only payment option available. I authorize Monona Academy of Dance to use my child's photo to promote or publicize the studio online or in print. I understand the physical demands and inherent risks involved in dance and guarantee the registered student to be in sound physical condition. I agree to hold Monona Academy of Dance LLC, its officers, agents and employees in both individual and official capacities, harmless from liability for injury, damage or loss to property or person as a result of participation in any Monona Academy of Dance LLC activities. I hereby agree that I will not send my dancer to class if they are exhibiting any COVID-19 or other flu like symptoms and/or severe cough. I acknowledge Monona Academy of Dance reserves the right to cancel any classes with inadequate enrollment. Enrollment with Monona Academy of Dance is August through June. Billing is done at the time of enrollment. Early withdrawals are not eligible for refunds for costume or recital deposits. Withdrawal notification is due 7 days prior to the start of the term. I have read, understand and will abide by the policies set forth in the Classes Tab of this website and by Monona Academy of Dance LLC. All policies are listed under the Classes Tab. Signature: Date: