Name *
Name
Address *
Address
Phone *
Phone
Cell Phone *
Cell Phone
Additional Phone Number (If Applicable)
Additional Phone Number (If Applicable)
Dancer Name *
Dancer Name
Sex *
Birth Date *
Birth Date
Boarding or Commuting *
Meal Plan
*If Commuting
Room Mate Preference
Class Age Division *
Showcase Performance Choice 01 *
Showcase Performance Choice 02 *
Showcase Performance Choice 03 *
Dancer Name 2
Dancer Name 2
Sex
Birth Date
Birth Date
Boarding or Commuting *
Meal Plan
*If Commuting
Room Mate Preference
Class Age Division
Showcase Performance Choice 01
Showcase Performance Choice 02
Showcase Performance Choice 03
Emergency Contact Name 01 *
Emergency Contact Name 01
Emergency Contact 01 *
Emergency Contact 01
Emergency Contact Name 02 *
Emergency Contact Name 02
Emergency Contact 02 *
Emergency Contact 02
*Please include physical, psychiatric or behavioral conditions
*If Yes, Please list
Does your child have Asthma? *
Enrollment Policy: Dancers are enrolled on a 'first come' basis. Deposit is due at time of enrollment, we cannot hold your space without a deposit. Cancellation Policy: A non-refundable processing fee of $100 will be retained if you have to cancel your child’s reservation and do so prior to your tuition due date. After that date, the full 25% deposit will be retained. I, the undersigned Parent or Guardian of the above student(s), release the Gold School, including instructors and assistants from any and all injuries which I may sustain while training, practicing, and performing or during any event or activity. I also agree that I am responsible for their health and accident insurance and any medical costs incurred due to injury. I also give my permission for emergency medical transportation and treatment at my expense if the need arises. I also give my permission for the public display of any NO BOUNDARIES photographs and video that my child may be in.