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Broadway Bound Dance Academy
Summer 2020 Registration Form

New Student: If you need help with proper class placement,
please call us at (610)891-9959.

Your tuition will be added to your Jackrabbit account within a few days after we receive this registration, and will be run on your credit card at that time. If you don't have a Jackrabbit account, please once you submit this form, please click on the link to the left that says "Jackrabbit Account" after submitting this form.

Please fill out one form per student (fields with (*) are required)

Student's Name (*):
Birth Date: / /
Parent's Name:
Home #:
Work #:
Cell #:
E-mail (*):
Are there any health concerns we should be aware of?
Please list all of the classes you will be taking in the YELLOW PHASE




If you are attending an in-studio summer dance camp during the YELLOW PHASE, please list the day and time.

Please list the in-studio classes you will be switching to once we are moved to the GREEN PHASE.

By signing this contract I agree to submit payment in a timely fashion for the duratoin of services rendered. I realize that no refunds will be given after the second class of the summer, but that if the student should decide after the first class not to continue, I will be given a full refund, minus a $5 processing fee. It is the student's responsibility to attend all classes, and there will be no refunds, discounts, or credits given for classes missed.

By signing this contract I understand that dance is a physical sport, and that there are certain risks involved including, but not limited to, sprained or broken limbs and pulled muscles. I agree that Broadway Bound Dance Academy L.L.C. and all those associated with it are not to be held responsible in the event of injury. I also understand that bringing money or others of value to the studio is at my own risk, and I will not hold Broadway Bound Dance Academy L.L.C. or anyone associated with it responsible in the event of my possessions are lost or stolen.

I have read and understand the agreement (*):


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