2017 - 2018 Registration Form
Questions marked by * are required.
1. Dancer's Name(s) (if more than one - please list youngest to oldest separated by commas) *
2. Date(s) of Birth: (MM/DD/YY) (please list youngest to oldest separated by commas) *
3. Student(s) Age(s) in September 2017 - (youngest to oldest separated by commas) *
4. Guardian #1 Name (First, Last) and Cell Phone Number: *
5. Guardian #2 Name (First, Last) and Cell Phone Number
6. Student Address Information: (street address) *
7. City *
8. Zip Code *
9. Apartment Number:
10. Preferred Phone Number *
11. Alternate Phone Number *
12. If you are a new dancer, please tell us how you heard about us? If someone referred you, please let us know.
13. If you are a new or returning student and you refer a friend you will both receive a free dance recital costume (a $65 value!). If you have a friend or relative you can refer please enter their name here:
14. Ave Maria Dance Academy utilizes email to communicate with parents. It is part of your commitment to stay informed of studio news and updates throughout the dance season by reading all emails, notices and monthly newsletters. Please type your initials into the box to confirm that you have read this statement.
15. Primary Email *
16. Secondary Email
17. Please choose your classes: (Company and Select Classes are by invitation only):
  • Ballet II – Mon/5-6:30pm
  • Jazz I/II – Mon/6:30-7:30pm
  • Ballet III - Mon/7:30-9pm
  • Tech. & Cond. II – Tues/4:30-5:30pm
  • Company II - Tues/5:30-6:30pm
  • Select – Tues/6:30-7:00pm
  • Tech. & Cond. III-Tues/7:00-8:00pm
  • Company III – Tues/8:00-9:00pm
  • Wee Dance – Wed/1-2pm
  • Ballet/Tap Combo – Wed/4:30-5:30pm
  • Ballet I - Wed/5:30-6:30pm
  • Lyrical – Wed/6:30-7:30pm
  • Theatrical Dance - Wed/7:30-8:30pm
  • Pointe Class - Wed/8:30-9:30pm
  • Hip-Hop-I/II - Thurs/5:00-6:00pm
  • Hip-Hop-III - Thurs/6:00-7:00pm
  • Tap I/II – Thurs/7:00-8:00pm
  • Tap III - Thurs/8:00-9:00pm
  • Beginner Tumbling – Fri/5-6pm
  • Int./Adv. Tumbling – Fri/6-7pm
  • Wee Dance - Sat/10-11am
  • Ballet/Tap Combo - Sat/11am-12pm
  • Ballet I – Sat/12:30-1:30pm
  • Company I - Sat/1:30-2:30pm
18. If it is not obvious please use this box to clarify which classes are for which child.
19. Are there any special instructions, medical conditions, or special needs for your child?
20. The annual registration fee along with your first month's tuition payment must be paid at the time of registration. Please choose your registration amount:
  • $25.00-Single Child
  • $40.00-Family
21. Please choose your tuition option: (if you need help calculating your tuition please call us - 239-261-2606 ext. 1)
  • Option 1: Pay registration and full annual tuition 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, the second payment is due by December 15th - receive a 5% discount on total tuition
  • Option 3: Pay your tuition monthly (by check, cash, credit/debit.) The first tuition payment and registration fee are due at the time of registration. Subsequent payments are due by the 1st of each month and are considered late after the 7th of the month. (A $10 late fee will be applied to your account on the 8th day of the month.)
22. If you wish you may sign up for auto-pay: (your tuition payment(s) according to the option you have chosen and the January recital fees (if any) will be processed automatically using the credit/debit card you provide) Auto pay ensures that your payment(s) will always be on time and you will never have to worry about a late fee! Please indicate your preference:
  • I wish to sign up for monthly auto-pay. I authorize Ave Maria Dance Academy to charge my credit/debit card on the 1st of every month for dance tuition as well as the recital fee ($35) and costume fee ($65) on January 1st
  • I have chosen option 2 or 3, please charge the card I am providing accordingly
  • I do not wish to sign up for auto-pay (skip to #26)
23. Card Number:
24. Card Expiration Date (mm/yy):
25. CVV CODE: (3 or 4 digit code on the back of your card)
26. In order to hold your child's place in class the registration fee and the 1st month’s tuition must be paid. Please select from the payment options below and then click the submit button.
  • I have included my credit card information, please charge my card according to the tuition option I have chosen
  • I will come in to the studio and pay in person (we cannot hold a place for your child in class until the fees are paid)
27. Don't leave yet! When you click submit you will be redirected to the parent agreement page :)
  • OK