SUMMERDANCE
SUMMERDANCE2020
Members$80 $70 Non-members$99 $89
CONTACT: ELIZABETH [email protected] | 781.682.5831
EARLY BIRD SPECIAL!register by April 15th to receive $10 OFF
JULY 14th - AUGUST 20th
per class
per class
R E G I S T R A T I O Nsummer dance
SESSION TUITION FEES: MEMBERS $80.00, NON-MEMBERS $99.00TUITION FEES ARE DUE BY THE FIRST CLASS OF EACH SESSION
TUITION FEES ARE FOR THE ENTIRE SESSION AND DO NOT VARY FOR ABSENCES OR CANCELLATIONSSESSION CLASSES MEET ONCE A WEEK FOR 6 WEEKS (6 CLASSES TOTAL)
**CLASSES WILL RUN BASED ON ADEQUATE ENROLLMENT**
FOR MORE INFO, CONTACT: ELIZABETH [email protected] | 781.682.5831
* sibling discounts available *
Student Name: ____________________________________ D.O.B. ___________ Age _____
Parent/Guardian’s Names: ______________________________________________________________
Address: ______________________________________ City ______________ State ____ Zip ________
Home Phone: ________________ Cell Phone #1 _________________ Cell Phone #2 _____________
E-mail(s): _______________________________________________________________________________
Emergency Contact & Phone: ___________________________________________________________
Allergies: _______________________________________________________________________________
Member:______ Non-Member:______ Returning Dancer:______ New Dancer:_____
Class Choices: ___________________________________________________________________________
2020
SIGNATURE: ______________________________________________________ DATE: _________________
STUDENT(S) NAME: ________________________________________________________________________
WEYMOUTH CLUB PROGRAM WAIVER
I hereby represent to Weymouth Club, its affiliated, shareholders, partners, officers, agents, servants, employees, and representatives (collectively
Weymouth Club) that I am in good physical condition and am able to safely participate in Weymouth Club programming. I acknowledge that Weymouth
Club urges every participant to have a medical check-up before participating in any Weymouth Club programs. I appreciate the danger of physical
stress, strain, or injury and assume whatever risk is involved as a result of my use of the facilities, equipment, or services of the Weymouth Club.
I hereby release and hold Weymouth Club harmless from and against any and all claims, liability, loss, damage, or injury sustained or incurred in
connection with my use of the facilities, equipment, or services of the Weymouth Club, and waive any and all claims against Weymouth Club from any
damage or liability resulting from or in the connection with such use, excepting such damage which may be caused by Weymouth Club negligence.
I hereby grant Weymouth Club consent and permission to use my name, portrait, image, statements and comments and to copyright, use and publish
the same in whole or in part, in any media for purposes relating to the business and activities of the Weymouth Club, including trade or advertising.
I hereby release and discharge Weymouth Club from any claims or demands arising out of or in connection with such uses, including but not limited to
any and all claims for libel or invasion of privacy.
I understand and agree that the program is not a therapy program, nor should it substitute for medical treatment.
This release, waiver and consent shall be binding upon me and my heirs, legal representatives and assigns.
Cash Check COF Club Bucks WC/GC
CC #: ___________________________________________________ EXP: __________CVV #: ___________
$25 fee for returned checks
Please fill out ALL information below, even if you have previously participated with Dance with Energy
DISCOVERY dancepink tights
solid color leotardpink ballet shoes
optional: skirt/tutu
Ballet & tap (ages 3-5) pink tights
solid color leotardpink ballet shoesblack tap shoes
optional: skirt/tutu
Ballet & tap (ages 5-7)pink tights
black leotardpink ballet shoesblack tap shoes
optional: skirt/tutu
intro to acrosolid color leotard
optional: acro shortsoptional: footless tights
FOR MORE INFO, CONTACT: ELIZABETH [email protected] | 781.682.5831
* sibling discounts available *
musical theatersolid color leotard or tank topblack jazz pants or capri pants
black jazz shoes or dance sneakersoptional: tights
hip hop (girls) solid color leotard or tank top
black jazz pants or shortsblack jazz sneakers or jazz shoes
optional: tights
hip hop (boys)solid color t-shirt
any color track/gym pants or jazz pantsblack jazz sneakers or regular sneakers
jazz & tapblack leotard
pink or tan tightstan jazz shoes
black tap shoesoptional: black shorts or capri pants
D R E S S C O D Esummer dance2020