_tjdance View Instagram post by _tjdance Aug 1 Open post by _tjdance with ID 18044765771603720 _tjdance View Instagram post by _tjdance Jul 31 Open post by _tjdance with ID 18093272267075612 _tjdance View Instagram post by _tjdance Jul 23 Open post by _tjdance with ID 18132825193570516 _tjdance View Instagram post by _tjdance Jul 21 Open post by _tjdance with ID 18097790764984546 _tjdance View Instagram post by _tjdance Jul 21 Open post by _tjdance with ID 18110736385766994 _tjdance View Instagram post by _tjdance Jul 19 Open post by _tjdance with ID 18329309713276705 _tjdance View Instagram post by _tjdance Jul 19 Open post by _tjdance with ID 18203968153315333 _tjdance View Instagram post by _tjdance Jul 17 Open post by _tjdance with ID 18603885550052478 _tjdance View Instagram post by _tjdance Jul 16 Open post by _tjdance with ID 18018124670898190 _tjdance View Instagram post by _tjdance Jul 13 Open post by _tjdance with ID 18086622146548366 _tjdance View Instagram post by _tjdance Jul 9 Open post by _tjdance with ID 18177017329415680 _tjdance View Instagram post by _tjdance Jul 9 Open post by _tjdance with ID 18089872259093646 _tjdance View Instagram post by _tjdance Jul 8 Open post by _tjdance with ID 17899534524527265 _tjdance View Instagram post by _tjdance Jul 8 Open post by _tjdance with ID 18234623515311850 _tjdance View Instagram post by _tjdance Jul 7 Open post by _tjdance with ID 18122485813689948 _tjdance View Instagram post by _tjdance Jul 7 Open post by _tjdance with ID 18005782064943556 _tjdance View Instagram post by _tjdance Jun 25 Open post by _tjdance with ID 17908090725430054 _tjdance View Instagram post by _tjdance Jun 21 Open post by _tjdance with ID 18318138601272072 _tjdance View Instagram post by _tjdance Jun 20 Open post by _tjdance with ID 18468376606101821 _tjdance View Instagram post by _tjdance Jun 19 Open post by _tjdance with ID 18101427713035950 Follow on Instagram Student Information Form If you've never taken a class with TJ Dance, or you're a current student who needs to make sure we have your latest information, this is the form for you! "*" indicates required fields How many students are you registering? 1 2 3 4 5 Parent Name if Student is a Minor FIrst Last Name of Student* First Last Student Birth Date* MM slash DD slash YYYY Gender* F M Student 2Name of Student 2 First Last Student 2 Birth Date MM slash DD slash YYYY Gender, Student 2 F M Student 3Name of Student 3 First Last Student 3 Birth Date MM slash DD slash YYYY Gender, Student 3 F M Student 4Name of Student 4 First Last Student 4 Birth Date MM slash DD slash YYYY Gender, Student 4 F M Student 5Name of Student 5 First Last Student 5 Birth Date MM slash DD slash YYYY Gender, Student 5 F M Contact InfoEmail* Main Phone*Is the above a home phone or cell phone?* Home Cell Emergency Phone*Name of Emergency Contact* First Last Your preference for being contacted?* Phone Email Text No Preference Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student Allergies or Concerns*June Recital Participation* Yes No Not Sure Classes I am enrolling in (Day, Time & Teacher):*Terms of Service - User AgreementTuition is due at your 1st class of the month. A $5 late fee may be added to tuition if you are more than one month past due.* I Agree Dance instruction may require instructors to touch the dancers body for proper placement.* I Agree You will be required to make a $50 costume deposit in December (due by Dec 1) or a costume will not be ordered for you or your child. If a costume is ordered, it is nonrefundable. You or your child will be required to participate in either the opening number or finale number, in addition to your class dances.* I Agree TJ Dance has my permission to use candid photos taken during classes and performances.* I Agree Medical Emergency: TJ Dance does not carry medical insurance for its students. If injury occurs it is understood that the students personal medical insurance will cover all costs. I give my permission for the Dance Teachers, Jayne Hancock and Peg Burnside, and other TJ Dance instructors to get medical attention for my child, in the event that a medical emergency should arise and I cannot be reached.* I Agree Liability Release: I hereby release the TJ Dance instructors, any guest instructors, any adults in charge, and the owners of the land and building of TJ Dance’s residency from any liability resulting in accident or injury while participating in any activity at TJ Dance. This also includes any activities in the waiting area or parking lot. TJ Dance does not supervise the waiting area or the parking lot. I certify that my level (or my child’s level) of physical condition determined by my physician or myself allows me to safely participate in classes. My signature states that I have read and understand this liability release.* I Agree
