KARMA'S DANCE FACTORY
2016-2017 REGISTRATION FORM
5808 Johnnycake Rd Woodlawn, MD 21207

New Student:
Returning Student:
Student's Name:
Address:
City:
State:
(e.g. NY, MD, OH)
Zip:
Email Address:
Home Phone:
Cell Phone:
Age:
Sex:
Birthdate Date:
(eg. 01/01/11)
PARENT/GUARDIAN INFORMATION
Mother:
Mother's Phone:
Mother's Email:
Father:
Father's Phone:
Father's Email:
IN CASE OF EMERGENCY
Name:
Relationship to Student:
Phone:
Alt. #:

I hereby waive Karma’s Dance Factory, Inc., from any claims, costs, liabilities, expenses or judgments,
including attorney’s fees and court costs that may arise from my/my child’s participation in this
program. I also understand that all tuition payments are non-refundable. KDFI reserves the right to
cancel classes due to low enrollment at anytime, in which case, all remaining tuition will be refunded.

All classes are subject to change without notice. I understand that my tuition payments are due on the
dates specified by the studio. I understand that I will not receive a refund for classes that I miss if they
are not made up during the current semester. I understand that non-attendance does not constitute
withdrawals from the program. In the case that I/my child withdraw from the program, I will notify
KDFI in writing 30 days in advance.

I understand that I have to pay the following fees: (ALL PAYMENTS ARE DUE THE LAST SATURDAY OF THE MONTH) $50.00 yearly registration fee (Sept. – May.) will apply to all students. $35.00 NSF Charge will be applied to all checks (that’s if Ms. Karma happens to take one) that are returned. A late fee of $5.00 per week will be applied to all late tuition payments up to $20.00 per month.
Ballet/Tap Tots
(Thursdays)
Ballet/Tap/Jazz (3-7 years old)
(Saturdays)
Ballet/Modern
(Fridays)
Advanced Ballet/Modern
(Saturdays)
Hip-Hop Tots
(Mondays)
Hip-Hop I
(Wednesdays)
Hip-Hop II (Mondays)
Hip-Hop (BOYS) (Thursdays, Saturdays)
Advanced Hip-Hop (Saturdays)
Kung Fu (Mondays, Wednesdays, Fridays)
Modern I (Mondays)
Rhythm & Rhyme (2.5-3 years old) (Saturdays)
Tap & Jazz (Tuesdays, Thursdays)
Parent's Signature: