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Rhythm Masters Performing Arts Center
Online Registration

Thanks for your interest in Rhythm Masters Performing Arts Center!

At Rhythm Masters PAC, we understand and respect confidentiality.  All information submitted will be kept in the utmost confidence!

Please complete the form below to complete registration online.  All fields that are colored RED, are required and must be filled in.  Any required information not obtained will void online registration and may require you to come into the studio and complete actual paperwork to register. 

Registration is not complete until registration fee of $25.00 per family is received.  Registration fee only applies to new dancers.  If you danced last season, the registration fee is waived.
(Links to pay registration fees are at the bottom of the registration form)

NOTE:  Family is designated as Mother, father, sister, brother, son, daughter, husband, wife, grandma, grandpa, grand-son, grand-daughter.

Parent / Guardian Information (only if dancer is under 18 years of age)

The name(s) listed here will be the only person(s) that will be permitted to pick up your dancer from the studio!  NO EXCEPTIONS, unless in writing!

First Name:       Last Name:  
First Name:         Last Name:   
First Name:         Last Name:   

If you need to include additional names, please come in and get a Parent / Guardian pick up Authorization Form.

Student Information

Student's First Name:     Middle Initial:     Student's Last Name:

Student's age:     Date of Birth: / / (please enter as mm/dd/yy)

What classes are you enrolling in? 1.   

                                                          2.       

                                                          3.       

If the class you want isn't listed please enter the Class Name and day here:

Any prior Dance experience? yes No  (please check one)
How did you hear about Rhythm Masters Performing Arts Center?    
If other specify:     (mark here only if you heard about us in some other way than what is listed)
If friend, please identify, so we may thank them for tell you about us: (mark here only if you heard about us through a friend)

Address Information

Street Address:         City:   

State:      Zip:        If in Canada, please put five "0" (zero's in required zip box) and list your zip code here:

Contact Information

Please put phone numbers in this format: 2695551212

Phone Numbers:    Home:     Work:     Cell:

E-mail Address: 

Health Information

Please fill in any health information that may pertain to your chosen classes.
*We do accept handicap students.* This information will not preclude a child's involvement
in a class. but it does help us tailor the class to each child's needs.
Upon registration each student/or parent will fill out a separate Health Form.

Emergency Contact Information

First Name:     Last Name:
Relationship to Dancer:     Phone Number: 

General Information (The following questions will help us learn more about your wants and needs, they are completely optional)

Are there any classes that aren't listed on the schedule, that you would like to see offered?
To assist in the cost of recital costumes and dancer expenses, would you be interested in fund raising? Yes    No
Would you be interested in trying out for our competition teams? Yes    No


Registration is almost complete!  Please read the Liability Disclaimer and then click the Submit button below.  This will complete Phase one (1) of registration.  After submitting this information, you may either pay via Pay-Pal or you may bring a check into the studio before the first class.  Add $5.00 processing fee on check payments. 


Liability Disclaimer

To my knowledge, I do not have any medical problems that would prevent me from participating in this activity / dance class.  I understand that it is my responsibility to obtain my physician’s consent to participate if any health problems are known to exist.  It is also my responsibility to inform the instructor of any health problems I might have, even if I have already obtained my physician’s approval for participation in any classes.

That I freely and knowingly assume the risks inherent in participating in any fitness/dance/aerobics health and exercise program and I hereby waive any right, claim, or cause of action against Rhythm Masters Performing Arts Center, its officers, directors, employees, and agents, and release them from any liability for any injury, cost, damage, expense, or claim which I or anyone on my behalf might have as a direct or indirect result of my participation in any fitness/dance/aerobics health or exercise program.

 



By submitting this information you acknowledge that you are the dancer registering or the legal guardian of the dancer and accept the terms of the Liability Disclaimer.  Liability disclaimer form will be signed on the first day of classes.