Register For Classes At Northland School of Dance

Ready to register for the 2021/2022 Dance Season? Fill out our Registration Form below:

2021 - 2022 Northland 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.

Step 1 of 5

Today's Date*
MM slash DD slash YYYY
Student Information
Student's Name*
First Last
Student's Date of Birth*
MM slash DD slash YYYY
Grade in School (2021 - 2022 school year)*
Receiving Trophy in June 2022 (3,5,8,10,13,15 years of dance study)
Address*
Street Address Address Line 2 City ZIP Code
Home Phone
Home Email
Student Email
Student Cell Number
Parent Information
Mother's Name*
First Last
Mother's Work Number*
Mother's Cell Number*
Mother's Email*
Mother's Occupation (optional)
Father's Name
First Last
Father's Work Number
Father's Cell Number
Father's Email
Father's Occupation (optional)

Classes
Class Choice*
- Recreational
- Pre-Competition (audition required)
- Competition (audition required)
Class Choice: List Day and Time.
For Competing Students - Do you wish to be an Unlimited Student?
(Unlimited Students commit to the program and its fees from September 2021 through May/June 2022)
Would you like Northland to design a personalized payment plan (P3) for you?*
Some families find that Personal Payment Plans (P3) are helpful for their budgets as all estimated costs that may come up throughout the year are averaged into 8 even payments that are automatically withdrawn from a pre-approved account each month. Any balance due or refunds coming are reconciled in the last 2 months.
Important Information About The P3 Payment Plan*
- Please check this box if you consent to have Northland staff charge your credit card on the first day of each month during the 2021/2022 dance season. This charge includes all P3 fees, as well as any other fees you request. Automatic payments will begin September 8, 2021 with the last payment at the end of the season. If you are unable to fulfill this obligation, you are required to contact NSOD staff IMMEDIATELY to discontinue the service.
Payment Options
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.
Registration Fee: $50 first student / $30 each additional student in the same family
I will arrange for BOTH Class and Registration payments by:*
- I will go to the Studio during open hours to make a payment in person
- I will call the Studio during open hours to make payment arrangements over the phone

How Did You Hear About Northland?
Your answer can help us to reach more dancers!*
- Website
- Facebook
- Mall Sign
- Competition
- Friend (please list name)
- Other
Name of Friend
If you chose 'Other' please list how you heard about Northland
Health History
Please list any health issues :

Room Parent
Are you an organized person that would like to be involved in your dancer's class as the Room Parent? Room Parents receive a monthly tuition discount. If you have been selected as Room Parent, you will be informed prior to the first lesson in September. There will be a meeting to learn how to effectively be a Room Parent. If you are interested, please sign up below.
Are you interested in becoming a room parent?*
Your Name
First Last
Your Phone Number
Your Email
Important Requirements For ALL Groups
I agree my child will perform in all performances and events in which their group participates.*
I agree to purchase costumes necessary to the group. (Includes all NSOD shoes, tights, accessories)*
I'm aware if I choose a P3 Payment Plan, the monthly fee is an eight-month commitment*
I agree if I discontinue lessons, I will pay for the full month, with no refunds, including registration fee.*
I am aware of and agree to pay a $20 late fee for any and all fees that are not paid by the due date. This includes lessons, costumes, competition and P3 payments. Auto pay clients never pay a late fee.*
I give Northland permission to use my picture of child's picture for advertising and promotional purposes.*
I'm aware and agree to pay a 3% lesson charge if not on automatic billing.*
COMP I, II, & PRECOMP ONLY: I'm aware that if my dancer(s) quit after audition results are announced, there will be a $100 charge per dancer, and agree to pay it upon notice.

Register

Secure placement in the class of your choice by sending your registration form and check for your registration fee to:
Northland School of Dance
12425 Champlin Drive
Champlin, MN 55316
Or, you may stop into the studio during open hours to pay in person.

New dancers, please stop by the studio to receive a tour and meet our staff.

No confirmation of your registration is necessary. You will be notified if there is a change to your class. Classes begin September 8.
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.*
Typing Your Name Below Will Be Considered Your Electronic Signature*
First Last
Untitled
- First Choice
- Second Choice
- Third Choice
Name
This field is for validation purposes and should be left unchanged.

Register For Classes At Northland School of Dance

Ready to register for the 2021/2022 Dance Season? Fill out our Registration Form below:

2021 - 2022 Northland Dance Season Registration

Step 1 of 5

Student Information

Parent Information

Classes

Payment Options

How Did You Hear About Northland?

Health History

Room Parent

Important Requirements For ALL Groups

Register

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.

Ricci Milan and our 2020 Seniors!

763-421-5443
Champlin, MN

Ready to register for the 2021/2022 Dance Season? Fill out our Registration Form below:

2021 - 2022 Northland Dance Season Registration

Step 1 of 5

Student Information

Parent Information

Classes

Payment Options

How Did You Hear About Northland?

Health History

Room Parent

Important Requirements For ALL Groups

Register

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.

Ricci Milan and our 2020 Seniors!

763-421-5443 Champlin, MN

763-421-5443
Champlin, MN