Register For Classes At Northland School of Dance Recreational Dance Technique Classes Pre-Comp Dance Competition Dance Boys Only Classes Precious Gems Special Needs Dance Adults Dance Classes Schedules subject to change Ready to register for the 2022/2023 Dance Season? Fill out our Registration Form below: If you’d prefer to download a form to print and bring in / mail in, we’ve provided one here. 2022 - 2023 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 20% Today's Date* MM slash DD slash YYYY Student InformationStudent's Name* First Last Student's Date of Birth* MM slash DD slash YYYY Grade in School (2022 - 2023 school year)*Please chooseK1st2nd3rd4th5th6th7th8th9th10th11th12thOtherReceiving Trophy in June 2023 (3,5,8,10,13,15 years of dance study) Address* Street Address Address Line 2 City ZIP Code Home PhoneHome Email Student Email Student Cell NumberParent InformationMother'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 NumberFather's Cell NumberFather's Email Father's Occupation (optional) ClassesClass 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?Choose yes or noYesNo(Unlimited Students commit to the program and its fees from September 2022 through May/June 2023)Would you like Northland to design a personalized payment plan (P3) for you?*Choose yes or noYesNoSome 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as all estimated costs that may come up throughout the year are averaged into 8 even payments that are automatically withdrawn from a pre-approved account each month.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 2022/2023 dance season. This charge includes all P3 fees, as well as any other fees you request. Automatic payments will begin September 7, 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 OptionsPlease 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 familyI 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 HistoryPlease list any health issues : Room ParentAre 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?*Choose yes or noYesNoYour Name First Last Your Phone NumberYour Email Important Requirements For ALL GroupsI agree my child will perform in all performances and events in which their group participates.*Choose yes or noYesNoI agree to purchase costumes necessary to the group. (Includes all NSOD shoes, tights, accessories)*Choose yes or noYesNoI'm aware P3 monthly fee is a commitment from start date to end date if I choose the P3 payment*Choose yes or noYesNoI agree if I discontinue lessons, I will pay for the full month, with no refunds, including registration fee.*Choose yes or noYesNoI am aware of and agree to pay a $30 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.*Choose yes or noYesNoI give Northland permission to use my picture of child's picture for advertising and promotional purposes.*Choose yes or noYesNoCOMP 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.Choose yes or noYesNoI'm aware that if choosing to pay with a credit card, I will be charged an additional 2% processing fee per transaction.*Choose yes or noYesNo Register Secure placement in the class of your choice by sending your registration form and check for your registration fee to:Northland School of Dance12425 Champlin DriveChamplin, 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 7.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.*Choose yes or noYesNoTyping Your Name Below Will Be Considered Your Electronic Signature* First Last NameThis field is for validation purposes and should be left unchanged. Δ
