Latest Updates for studio, company & competition
6 Reasons to Consider Synergy/MMSPA
2008-2009 Printable Registration Form-Synergy Dance Academy-MMSPA
Register early to get the classes you want and as an added perk your registration gets you in line for ticket reservations (no long lines at recital time!) Pre-registration through June 12, 2008 is $10. Early registration thru Aug. 16th is $15 per student, Regular Registration $20 Aug. 17th-Sept. 2nd, Late Registration $25 after Sept. 2nd. Classes begin Sept 4th, 2007.
Account Last Name___________________________________________________Home #_______________
Address____________________________________________________ City__________Zip_______________
Email_______________________________________________________@_____________________________
Mother's Name:_________________________________wk#___________________Cell #_________________
Mother's Name:_________________________________wk#___________________Cell #_________________
Student's Name:______________________________________________Age_____Birthdate______________
Clothing Size: List Classes:
Student's Name:______________________________________________Age_____Birthdate______________
Clothing Size: List Classes:
Student's Name:______________________________________________Age_____Birthdate______________
Clothing Size: List Classes:
Referral: Please let us know if someone from our studio referred you!____________________________________
Insurance/Liability Waiver: By signing below you are acknowledging that you understand that with any physical activity there are inherent risks and if you or anyone in your family should require medical attention as a result of participating in physical activities at Synergy Dance Academy, Mid-Michigan School of Performing Arts or outside related activities such as parades, competitions, recitals, outside performances, etc, you will hold Synergy Dance Academy, Mid-Michigan School of Performing Arts and all related agents thereof free of liability of any such injury sustained through participation and you also agree that you and/or your medical insurance will cover any such related expenses.
Payment Agreement: I understand my monthly tuition amount is: $________ and is due on or before the 1st of each month with auto-pay.
- ____I have attached a canceled check for automatic monthly deductions from my checking account for regular tuition.
- ____Please use the following credit card number below for automatic monthly charges for regular monthly tuition amount.
- V or MC# ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ exp _____/_____ 3 digit code on back ___ ___ ___ Account Holder's Printed Name__________________________________Signature___________________________
- ____I have pre-written checks for the first 6 months of classes and will write the remaining three once the account is balanced in February.
Changes/Cancellations must be made in writing by using a change form (located in studio lobby) 15 days prior to the next monthly billing cycle to be reflected on such.