Register For Classes At Northland School of Dance

2018 - 2019 Dance Season Registration

This form is required for all students, both new and returning, that wish to attend any class at Northland School of Dance. If you prefer, you can print the registration form and mail it or bring it into the studio in person. Download the form here.

Step 1 of 7

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Today's Date*
Student Information
Student's Name*
First Last
Student's Date of Birth*
Grade in School (as of September 2018)*
Returning Students: Are you receiving a trophy in July 2019 production? (3,5,8,10,13,15 years of dance study) Please specify.*
Student Email
Student Home Phone Number
Student Cell Number
Student Home Address*
Street Address Address Line 2 City State ZIP Code

Parent Information
Parent #1*
Prefix First Last
Parent #1 Work Number*
Parent #1 Cell Number*
Parent #1 Email*
Parent #2 Name
Prefix First Last
Parent #2 Work Number
Parent #2 Cell Number
Parent #2 Email

Classes
Class Choice*
- Recreational
- Pre-Competition (audition required)
- Competition (audition required)
Recreational Class Choice: List Day and Time.
For Competing Students - Do you wish to be an Unlimited Student?
(To take unlimited classes you must be committed to the unlimited fee for 10 months of the year)
Available to all students: Would you like Northland to design a personalized payment plan (p3) for you?*
Payment
Please come in to the studio or call Barb at 763-421-5443 during studio hours to accept payment information over the phone. Registration is not considered complete until payment is made.
I will pay by:*
- I will go to the Studio during open hours for payment
- I will call the Studio during open hours to make payment arrangements over the phone

Health History
Please list any of the following health problems, and explain:
Vision / Hearing*
Please explain vision / hearing concerns:*
Back / Knees / Hips*
Please explain Back / Knee / Hip concerns:*
Asthma*
Please explain Asthma concerns:*
Please explain any other health concerns:*

How did you hear about us?
How did you hear about Northland School of Dance?*
If you heard about Northland from a friend or student, please list their name below:
Room Parent
You are important! We are looking for a responsible parent to give the opportunity of being a Room Parent. To thank you for the work you will do for you group, we will be giving you a discount on your monthly tuition. There will be a room parent’s meeting to teach you how to do this job. If you are interested, fill in your information. You will be informed on your first lesson in September if you have been chosen for your group.
Are you interested in becoming a room parent?*
Your Name
First Last
Your Phone Number
Your Email

Important Requirements For Groups
I agree my child will perform in all performances and events in which their group participates.*
I agree to purchase class costumes necessary to the group.*
I agree to purchase the required Northland tights, shoes, hair piece and accessories for costume.
I am aware dance lesson fees are a 10 month commitment, but with a 9 month payment plan.*
I am aware should lessons be discontinued, I will pay for the full month, with no refunds, including the registration fee.*
I am aware there is a $20 late fee for any individual fees that are not paid by the due date. This includes lessons, costumes, competition, YEP and workshop fees. If on a (P3), there will be a monthly late fee of $20. Auto pay never pay a late fee.*
I understand that Northland School of Dance will use photos/video of studio related events, including classroom instruction, workshops, events, and Year End Production for advertising / promotional purposes.*

I hereby release all persons affiliated with Northland School of Dance from any and all claims for damages or injuries which may be sustained while participating in any and all activities connected with Northland School of Dance. I also agree to adhere to all policies of Northland School of Dance.
By selecting either a 'yes' or 'no' response below, and providing your name and clicking 'Register' you are agreeing to use this as an electronic signature.
I understand the above information, and I have filled out this form accurately and completely to the best of my knowledge. I understand that by not accepting any part of the terms and conditions, it may not be possible to be accepted in a class or competition company.*
Your Name*
First Last
Name
This field is for validation purposes and should be left unchanged.

Register For Classes At Northland School of Dance

2018 - 2019 Dance Season Registration

Step 1 of 7

Student Information

Parent Information

Classes

Payment

Health History

How did you hear about us?

Room Parent

Important Requirements For Groups

I hereby release all persons affiliated with Northland School of Dance from any and all claims for damages or injuries which may be sustained while participating in any and all activities connected with Northland School of Dance. I also agree to adhere to all policies of Northland School of Dance.

Today On Our Blog

Congratulations to Bella Ford on being accepted to the Joffrey Summer Intensive!

Blog Topics

763-421-5443
Champlin, MN

2018 - 2019 Dance Season Registration

Step 1 of 7

Student Information

Parent Information

Classes

Payment

Health History

How did you hear about us?

Room Parent

Important Requirements For Groups

I hereby release all persons affiliated with Northland School of Dance from any and all claims for damages or injuries which may be sustained while participating in any and all activities connected with Northland School of Dance. I also agree to adhere to all policies of Northland School of Dance.

Today On Our Blog

Blog Topics

763-421-5443 Champlin, MN

763-421-5443
Champlin, MN