Full Season Registration - Premiere Dance Academy

Student Information

Student Name*

First Last

Student Gender*

Birth Date*

Age*

School attending in Fall*

Grade in the Fall*

Medical Info

(Allergies, limitations, concerns)

Contact Information

Home Address*

Street Address Address Line 2 City State ZIP Code

Home Phone*

Parent/Guardian Information

Parent/Guardian 1 Relationship*

Parent/Guardian 1 Name*

First Last

Parent/Guardian 1 Email*

This will be the primary email for the account

Enter Email Confirm Email

Parent 1 Mobile Phone*

Parent 1 Birthdate*

Parent 1 Work Phone

Parent/Guardian 2 Relationship

Parent 2 Name

First Last

Parent/Guardian 2 Email

Enter Email Confirm Email

Parent 2 Mobile Phone

Parent 2 Birthdate

Parent 2 Work Phone

Scheduling Information

Recreational Dancer Conflicts

Our Recreational Classes can take place Mondays through Fridays between 4:15PM-9:45PM and Saturday Mornings from 9:30AM-1:30PM. Any CRUCIAL conflicts that you may have for the upcoming year can be listed here. Please be specific with times and keep in mind that we can not place your child appropriately if you have too many conflicts. Competition Dancers should have open availability without conflicts and are scheduled throughout the week.

Classes

Please indicate the classes you are in enrolling in.

Reminder: Dads n Dollz Registration is in the fall

PLEASE NOTE: If you are auditioning for a Company Team or Pom Team and have not previously been on a team, please register for the recreational classes you would enroll in if you do not get placed on a competitive line. That way we can schedule you appropriately! If you make a team, we will work with you to adjust your registration accordingly. Dancers on a Pom team must also enroll in at least one recreational class (either Tap/Jazz, Lyrical or Ballet)

Product Name*

A $38 non-refundable registration fee per dancers is due with this form as well as your costume deposit(s) below

Price:

Recreational Classes

There is a $43 costume deposit PER CLASS that your child is enrolled in. The rest of your costume fees will be included with your monthly tuition (this does not include tights, dance shoes or dancewear for class). You will not receive an additional bill for costumes.

Jazz/Tap Combination (4-18yrs: must be 4 by Sept. 1st)
Ballet (Kindergarten and up)
Lyrical (2nd grade & up)
Hip Hop (2nd grade & up)
FULL- CONTACT FOR WAITLIST: Boys Hip Hop (4 yrs & up: Must be 4 by Sept. 1st)

Competition classes

(must be pre-qualified)
$48 costume deposit PER CLASS that your child is enrolled in. Please Note: Hip hop is for Previous Petite Performers through Senior Elites. Ballet is required for all dancers but only ouryoungest dancers will perform a routine in the recital. We will charge those costume deposits after auditions

Competition Jazz (Required)
Competition Tap (Required)
Competition Lyrical (Elite Lines Required)
Competition Ballet (Required)
Competition Hip Hop (Optional- see requirements above)
Pom

Agreements

Dance Participant Liability Waiver and Release Form This Waiver and Release Form (“Release”) is entered into by and between Premiere Dance Academy, LLC, (“Premiere Dance”) and Schulberg Enterprises, LLC, Participant, (collectively the “Parties”) as of this 2024-2025 dance season. WHEREAS, Participant wishes to engage in dance activities at Premiere Dance, Schulberg Enterprises, and Schulberg properties, and WHEREAS, Participant understands that dance activities can be physically demanding; and WHEREAS, Participant understands that the potential for physical injury is inherent in any and all physical activity including dance activities; and NOW, THEREFORE, for good and valuable consideration, the sufficiency of which is hereby acknowledged, the Parties covenant and agree as follows: 1. Premiere Dance agrees to offer Participant dance lessons and other services where Participant will participate in the activities of Premiere Dance, Schulberg Enterprises and Schulberg properties. As part of this participation, Participant will obtain valuable dance skills and experience. 2. Participant agrees not to hold Premiere Dance, Schulberg Enterprises LLC, or its agents, officers or employers, liable for any claims, actions, losses, costs or expenses that may arise in connection with Participant’s participation as a student and/or instructors/owners whether at the Premiere Dance facility, Schulberg Enterprises LLC Facility, or some other location. Participant agrees that this Release shall be construed as broadly as possible, and that if any portion is held invalid, those provisions not deemed to be invalid shall continue in full force and effect. 3. Participant is aware that this is a release of liability and an acknowledgement of his/her voluntary and knowing assumption of the risk of injury. Participant has signed this document voluntarily and of his/her own free will in exchange for the privilege of participation. 4. If Participant is a minor child, a parent or guardian has signed this waiver and release acknowledging the same risks to their child inherent in dance activities. Participant’s parent or guardian also represents that the minor child has the parent or guardian’s permission to participate in dance activities at Premiere Dance, Schulberg Enterprises LLC. 5. Signing below is also acknowledgement that the Parent(s)/Guardian(s) will be fully responsible and agree to make on time payments to Premiere Dance Academy, LLC for Participant’s dance fees including but not limited to: tuition, costumes, competition fees, tights, shoes, etc. as applicable. Past due accounts may be subject to late fee charges and/or debt collections. Pursuant to Minnesota Statute § 604.055, this waiver and release does not purport or intend to waive liability for damage, injuries, or death resulting from conduct that constitutes greater than ordinary negligence. Nothing in this liability waiver and release shall be deemed to grant Participant any warranty as to dance abilities prior to, or after engaging with Premiere Dance, Schulberg Enterprises LLC.

I grant my permission for Premiere Dance Academy to use photographs or video clips of my child.*

Yes
No

Parent/Legal Guardian Digital Signature*

By typing my name below, I agree to the terms listed above.

Total

$0.00

Payment

Coupon

Total

$0.00

Billing Address*

Same as Home Address

Street Address Address Line 2 City State ZIP Code

Credit Card*

Card Details

Cardholder Name

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Phone

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