step 1 of 2 of registration      

A $25 non-refundable deposit required to reserve class and complete registration.
If you are registering for a summer camp the full amount due must be paid. Dance Camps $95 and Workshops $25.
Thank you.

 
 

Location:     

How did you Hear about us?   Other



Student:: Phone:

Address:

City: Zip Code:

Date Of Birth (XX/XX/XX): Age: Gender:

Do you have prior dance training?

If so, where?

What style(s) of dance did you study?

How many years?

Choose classes from schedule page click here
Enter class choice(s) below.
*Please contact us if you need to enroll in more than 6 classes.
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If you are pre-registering for a class not listed above or do not see the class you'd like to register for please type in this box which class


IMPORTANT PARENT INFORMATION:*** Please note we will be communicating and distributing important information via e-mail, such as scheduling info., forms, reminders, etc. Please write the e-mail address of the adult that this information should be sent to, as the
Contact e-mail. The contact e-mail and the information assigned to the contact name should be for the same individual. Due to the number of students we have enrolled, we are ONLY ABLE to issue ONE SET of papers - to be given to the contact name. (This includes schedule info and all recital information). Please make any necessary copies and coordinate distribution of appropriate paperwork and info to all other parties.

Parent/Guardian: (if under 18)

Relationship to Student:

Home Phone: Work Phone:

Cell Phone: Email:



Alternate Emergency Contact: 

Relation To Student:

Home Phone: Work Phone:

Cell Phone:

Preferred Hospital:

Physician:




Health Concerns
Are there any health concerns that you or your child have that we should be aware of? (Ex: Asthma, knee injury, medications ext.)
    




Who will be allowed to pick up your children?

*Note: If anyone other than yourself comes to pick up your child, they will have to show a picture I.D.. If their name is not on this list or they do not have an I.D., we will be giving you a call to confirm with you that they are allowed to pick up your child. If we cannot reach you by telephone, they will not be allowed to leave with your child. This is for your child’s safety and protection.
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Please read and sign: Liability Release Form

In consideration of receiving dance instruction including special classes in tumbling, hip hop, lyrical, etc....and other good and valuable consideration, hereby release and forever discharge the said B & A, Inc. DBA Dance Matrix (Andrea and Bryan Clark and all other instructors) their assistants, agents, servants and/or employees and their families, of any and all claims for damage or damages of any kind, nature or description; more particularly which may grow out of receiving dance instruction or participation in dance classes or other physical exercise or movement. You must further release B & A, Inc. DBA Dance Matrix (Andrea and Bryan Clark, and all instructors) from any and all demands, claims, causes of action, suits or liabilities whatsoever, of every name and nature, both in law or in equity; more especially on account of participation in classes taken at Dance Matrix.

Date:    Full Name:
Signature required of Student (if over 18) or of Parent/or Legal Guardian (under


Dance Matrix Policies
 

Student(s) Name(s):
Please read and initial below, indicating that you understand and agree to the following:

Tuition: The cost of lessons is based on a full season schedule.  You can choose to pay a full session and receive a 5% discount or have your account debited monthly. To start there is a $25.00 registration fee per student or $40 per family which will need to be renewed every September. Tuition is debited between the 1st and the 7th (your choice of day) of every month.  Subsequently, there will be a $20 charge for non sufficient funds or your credit card not being up to date.  You are responsible to update the office with updated account information.  Your account must be current in order for the student to participate in classes, concerts, performances, conventions and competitions.  If a cancellation of a class or classes is to occur, a 30-day written notice prior to the 1st of next month is required.  If the notice is not given 30 days prior to the next due date the account will be drafted and there will be no refunds granted.  The notice has to be in person by filling out and signing the class change form in the office.  Outstanding balances, if any, need to be paid at that time.  Remember that there will be absolutely no refunds given for classes unattended.  Excused absences can be made up.

(initials here)  Attendance: Attendance plays a vital part in how well you or your child will progress in dancing.  As a child it can be frustrating to fall behind and frustrating to the rest of their classmates if there are excessive absences.  1Please make every effort to be in class and to notify the studio by telephone if a student must miss a class. You may arrange a make-up class at that time.  Make-ups should be made within two weeks of the missed class.  Students do not need to make up missed classes for holidays because they are already accounted for in the fifth lesson of some months.  If you are investing your time, energy and money into quality dance education, please give it your full attention. Credit is not given for absences.

(initials here)   Class Changes: If a student finds it necessary to drop a class, please notify the front desk to fill out the change form. If a student needs to withdraw from all classes, a withdrawal form must be completed, as tuition will continue to accumulate until the Withdrawal Form has been completed and signed.  A 30 day notice is required for the payment changes to become effective on the 1st of the following month.

(initials here)   Dress Attire: We do enforce a DRESS CODE.  To “look like a dancer” encourages one to conduct oneself  like a dancer. Students not dressed according to the dress code will not be permitted to take class. Please check the dress code(s) for your dancer’s class (es). Ballet classes must wear the color leotard specific to their class level. Please ask your instructor or front desk as to what color you are to wear. Our dress code is also posted in the office and on our website to refer to.  There will be no gum chewing, eating, or drinking in the dance studio.  Water is allowed to be kept in the students break room only.  No jewelry is to be worn for safety reasons and we will not be responsible for damage or loss.  Hair must be secured away from the face and neck for all classes.  Buns must be worn in ballet classes.  Please label all of your dance items with student's name.

(initials here)   Dance Matrix is hereby granted permission to take photographs of students for use in brochures, web sites, posters, advertisements and other promotional materials created by the school.  Permission is also hereby granted for the dance studio to copyright such photographs in its name.

(initials here)  Check In: All students must check in and out.  A key tag will be given to every parent of each student to swipe the scanner each  time they bring student to class.  With parent  approval,  if your child is of at least 12 yrs of age they can be responsible for  their own key tag and for giving their parents updated information given in the office.  If  lost or stolen it is a $10.00 fee to replace your key tag. 

 (initials here) Students are expected to have their own accident and medical insurance either under their parent's coverage or their own.  All instructors of Dance Matrix are safety conscious and follow appropriate safety procedures.  Dance Matrix will be held harmless from liability or claims resulting from your child's participation in the studio dance training program.
 
(initials here)  Patience and understanding are essential because all children learn at a different pace.  Please do not compare your child’s progress to any other.  If you have any reasons for concern about your child or their instructor/s please set up an appointment with the front desk for a private conference. You will receive our attention, respect, and gratitude.  If an instructor has any concerns in regard to your child's progress, you will be contacted.

(initials here)  Arriving/Departing: All students are requested to arrive 5 minutes early for their lesson.  Be sure to use the restroom, put       proper shoes on, hair tied up, etc.  While on the premises of the studio, students and siblings should conduct themselves in an orderly fashion.  Please be courteous to fellow parents in the waiting area.  If you have other children please keep them seated.  We have a student lounge  room for our student’s convenience.  Students are to remain inside until picked up by a parent.  Parental permission must be on file for students them go to other areas in the plaza.  The studio and office are not play areas, please use the lounge for quiet activities.  Parents will be held responsible for fixing or replacing any vandalism of the Dance Studio property.

 (initials here)  Annual Spring Concert: Detailed information about the will be available in Nov/Dec. The Concert will be held in April/May of
each year.  Costume deposits are due by November.  The remainder of the costume fees will be due in February.  All students are  
eligible to perform in these concerts.  If your student will not be participating in the concert, please inform the office and the
instructor as soon as information becomes available for the upcoming concert. 

We encourage our families to share their excitement about Dance Matrix with their friends and families. Any currently enrolled student who refers a friend who registers and pays their first month’s tuition will receive $5.00 off their next month (only one discount per month). There is no limit to the number of referrals a student may receive.

(initials here) Please check yes or no below AND initial, indicating you read the following:
We are sometimes approached by students requesting medication for a headache, or other minor ailments. Do we have permission to dispense the following medication to your student, per the manufacturer dosage recommendation?

Child's Name:   Tylenol: Yes No     Advil: Yes No

Child's Name:   Tylenol: Yes No     Advil: Yes No

Child's Name:   Tylenol: Yes No     Advil: Yes No

Child's Name:   Tylenol: Yes No     Advil: Yes No  

TUITION is payable in advance on a monthly basis.  All accounts are required to have a credit or debit card  or a checking account on file.  Monthly tuition will automatically be charged to that account or card on the 1st-7th (you indicated) of each month.  We do not send statements.  A fee of $20 will be charged if, for any reason tuition is not paid by the 7th of the month (card not up to date or non sufficient funds).  Once a student becomes inactive and the 30 day notice in writing has been filed the card or account on file will no longer be charged.

OPTIONS OF MONTHLY PAYMENT:

Credit Card Draft:  Please come in to fill out Credit Card Form for this service.
Check Draft: Please come in and bring a voided check for this service.

 
     
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For more information call 480-987-3073
OPEN at the SW corner of Combs and
Gantzel next to Fry's Marketplace.
OR 928-536-9993 Also OPEN at the
East side of Hwy 77, across street from
Sonic, next to Hancock Insurance.
Queen Creek / San Tan Valley
Snowflake / Taylor
85 W. Combs
Suite #108
San Tan Valley, AZ 85140
480-987-3073

google map
121 N. Main St.
Bldg. A
Taylor, AZ 85939
928-536-9993
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