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Carthage Fall 2026 Registration
Celebration School of Dance 62 S. Madison St. Carthage, Illinois
Student’s Full Name
*
Student’s Birthdate
*
Allergies/Medical Conditions
Anything you would like instructors to know about your child?
Parent/Guardian Name & cell # (your cell # for adult students)
*
Emergency contact-Name & cell #
*
Classes will be held every Tuesday starting August 4. Please select desired classes;
Classes will be held every Tuesday starting August 4. Please select desired classes;
Ages 2-4 Combo Class 5:00-5:30 pm
Ballet II/Jazz II 5:30-6:00 pm
Ages 4-6 Combo (Ballet & Tap) 5:30-6:00 pm
Tumbling I 6:00-6:30 pm
Ballet I/Jazz I 6:00-6:30 pm
Tumbling II 6:30-7:00 pm
Kids Clogging II 6:30-7:00 pm
Tumbling III 7:00-7:30 pm
Kids Clogging I 7:00-7:30 pm
Tumbling IV 7:30-8:00 pm
Beginner Clogging (All ages) 7:30-8:00 pm
Adult Clogging 8:00-8:30 pm
Adult Ballet/Jazz 8:30-9:00 pm
TUITION & PAYMENT AGREEMENT Tuition reserves your student’s spot in class and is due the first class of each month regardless of attendance. Missed classes are non-refundable. If classes are canceled more than two times in an 8-month period (due to weather or instructor emergencies) make up classes will be scheduled. Recital costumes will be billed separately. If your account has a remaining balance from a previous season, payment in full will be required before registering for an upcoming session.
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TUITION & PAYMENT AGREEMENT Tuition reserves your student’s spot in class and is due the first class of each month regardless of attendance. Missed classes are non-refundable. If classes are canceled more than two times in an 8-month period (due to weather or instructor emergencies) make up classes will be scheduled. Recital costumes will be billed separately. If your account has a remaining balance from a previous season, payment in full will be required before registering for an upcoming session.
I understand & agree
Celebration School of Dance may use photos/videos for: * Studio social media * Website * Promotional materials * Recital programs
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Celebration School of Dance may use photos/videos for: * Studio social media * Website * Promotional materials * Recital programs
A
Yes, full permission
B
No, I do not give permission
C
Other, I will discuss with staff
MEDICAL AUTHORIZATION In the event of illness or injury, if a parent/guardian or emergency contact cannot be reached, I authorize studio staff to seek appropriate medical treatment for my child/myself.
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MEDICAL AUTHORIZATION In the event of illness or injury, if a parent/guardian or emergency contact cannot be reached, I authorize studio staff to seek appropriate medical treatment for my child/myself.
I understand & agree
ASSUMPTION OF RISK / HOLD HARMLESS AGREEMENT Dance and tumbling involve physical activity including, but not limited to, stretching, jumping, balancing, spotting, and tumbling skills, which carry inherent risk of injury. I voluntarily assume all risks associated with participation. I agree to release, indemnify, and hold harmless Celebration School of Dance, its owners, instructors, assistants, and volunteers from claims arising from participation, except where prohibited by law.
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ASSUMPTION OF RISK / HOLD HARMLESS AGREEMENT Dance and tumbling involve physical activity including, but not limited to, stretching, jumping, balancing, spotting, and tumbling skills, which carry inherent risk of injury. I voluntarily assume all risks associated with participation. I agree to release, indemnify, and hold harmless Celebration School of Dance, its owners, instructors, assistants, and volunteers from claims arising from participation, except where prohibited by law.
I understand & agree
I acknowledge that this electronic signature has the same legal effect as my handwritten signature.
*
Signature
Submit