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                                                      AVE MARIA DANCE ACADEMY

                                                      Click Here For Printable Registration Form
                                                      or Register for Classes Using the Online Form Below

                                                      2011-2012 - Drama Class Registration
                                                      Please fill out all fields with an asterisk. When you are finished filling out the form be sure to click on submit and you will receive a confirmation email.
                                                      1. Student Name(s): If registering multiple children list names in age order (youngest to oldest) separating each with a comma. *
                                                      2. Address: *
                                                      3. City; Zip *
                                                      4. Age; School; Grade; Gender - If registering multiple children list names in age order (youngest to oldest) separating each with a comma. *
                                                      5. Please indicate the number of years your child has taken acting classes? (if zero, put '0' in the box) If registering multiple children list answer in age order (youngest to oldest) separating each with a comma. * *
                                                      6. Guardian #1 Name: *
                                                      7. Ave Children’s Theater utilizes email to communicate with parents. It is part of your commitment to stay informed of studio news and updates throughout the season by reading all emails. All emails will have: Ave Children’s Theater in the subject line. Please type your initials into the box to confirm that you have read this statement. *
                                                      8. Guardian #1 email: *
                                                      9. Guardian #1 - Home, Work, and Cell phone numbers in order (please separate answers with commas) *
                                                      10. Guardian #2 Name:
                                                      11. Guardian #2 email:
                                                      12. Guardian #2 - Home, Work, and Cell phone numbers in order (please separate answers with commas)
                                                      13. Emergency Contact Name; Phone # *
                                                      14. Are there any special instructions, medical conditions, or special needs for your child?
                                                      15. Please tell us how you heard about us? If someone referred you, please let us know. *
                                                      16. Please read and intitial the following waiver: I agree to release and discharge Ave Children’s Theatre and its officers, directors and agents of and from any claims, demands or liability of damage arising from the participation of my child in any classes and programs sponsored by Ave Children’s Theatre. *
                                                      17. Please choose your drama class(es) *
                                                      • ACT 1 – ages 5-10
                                                      • ACT 2 – ages 11 and up
                                                      18. If it is not obvious please tell us which class is for which child.
                                                      19. Please choose your registration fee: (Registration fee is due at the time of registration.) *
                                                      • Individual/$15
                                                      • Family/$25
                                                      20. Please choose the appropriate tuition fee: Monthly tuition payment is due at the first class of the month and is considered later after the 10th of the month (a $10 late fee will be applied after the 10th of the month, $15 after the 15th, $20 after the 20th). *
                                                      • 1 Child $45/mo.
                                                      • 2 children $81/mo.
                                                      • 3 children $121.50/mo
                                                      • 4 children $162.00/mo.
                                                      21. Please choose your tuition option *
                                                      • Option 1: Pay registration and full tuition for the dance season at the time of registration (receive a 10% discount on total tuition.)
                                                      • Option 2: Pay tuition in 2 payments. First payment and registration fee are due at the time of registration, second Payment is due by January 1st (receive a 5% discount on total tuition.)
                                                      • Option 3: Pay your tuition in 9 monthly payments starting in September and ending in May. First tuition payment and registration fee are due at the time of registration.
                                                      22. If you wish you may sign up for the automatic payment option; you will receive $5 off your monthly tuition amount and you will never have to pay a late fee! Please indicate your preference: *
                                                      • I do not wish to sign up for automatic payments at this time.
                                                      • I wish to sign up for automatic payments. (Each month on the first of the month your tuition payment will be processed automatically.)
                                                      23. Please provide the credit/debit card number and expiration date (mm/yy)
                                                      24. Clicking on 'submit' will forward your registration to us and redirect you to PayPal where you can complete your registration by posting payment. If you've signed up for auto pay or wish to pay in person please indicate by checking the appropriate box and disregard the redirect. If you need help figuring out your total call us: 239-261-2606 *
                                                      • I wish to pay through PayPal
                                                      • I will come in to the studio and pay in person
                                                      • I signed up for automatic payment, please charge my card