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Summer 2017 Registration below:

Please read the CLASS DESCRIPTIONS and SCHEDULE in the "Dance Classes" tab before registering your student for Summer 2017!


*Please note* 
Sometimes submitting this form via a smart phone or a tablet does not go through.  Send us an email to verify we received it.

All students are required to pay the registration fee to secure your class placement!
 
SUMMER 2017 REGISTRATION
NAME
AGE
Grade Entering
Mailing address:
City
State
Zip code
CURRENT PHONE #
CURRENT EMAIL ADDRESS:
EMERGENCY CONTACT
ADDITIONAL INFO:
Classes enrolling for:
Performance Team
Clogging Bootcamp
Beginner Clogging
Beginner Hip Hop
Lyrical
By submitting this form, I agree I have read and understand the tuition policies with Northern Explosion Dance & Fitness. Tuition Payments made after the 1st of each month will be charged $10 late fee (initial & date)
Liability disclaimer: It is understood that NEDS and it’s instructors cannot be held liable for any loss, damage accident or injury of any kind that may occur inside and/or outside of the dance building. It is also understood that NEDS is not responsible for any medical or hospitalization expenses that may result of an injury that occurred at the dance studio or while being affiliated with the dance studio at an outside venue. Any and all medical expenses will be covered by the parents/guardians own insurance. Each student may decline to participate in any activity, which he or she deems to be harmful. The student (or parent, if child is under 18) is responsible to inform the instructor in writing of any physical limitations which may prevent full participation in class. Signed:____________________________________________________ Date: ___/___/2017
 
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