INSTRUCTIONS: This form can NOT be filled out and submitted online. It must be PRINTED OUT on your computer printer, filled in by hand and mailed along with your check. The only lines that need to be completed are your name, child's name, address, phone number and the class description from the schedule. You MUST sign and date the form at the bottom. The other lines on the form are optional and can be filled in later. After you have filled in the above information and signed and dated the form at the bottom, please enclose your check made payable to Nelson Dance Center and mail it to us at the address on the form. Please phone us should you have any questions.

GIFT CERTIFICATES
GIVE THE LIFELONG GIFT OF DANCE! OUR GIFT CERTIFICATES MAKE THE PERFECT CHRISTMAS,
VALENTINE, EASTER, MOTHER'S DAY, ANNIVERSARY, BIRTHDAY, OR OTHER SPECIAL OCCASION GIFT!

Enroll Now! Phone (630) 584-2535
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Leadership in Dance Instruction
Nelson Dance Center
1901 W. Main Street ~ St. Charles, IL 60174 ~ Telephone (630) 584-2535 ~ www.nelsondance.com

ENROLLMENT AGREEMENT:

Date_________________ Original__________ Renewal__________ Extension__________
Parent of_______________________________________________________ Age__________
Name__________________________ Home Phone__________ Business Phone__________
Home Address: Street_______________________ City_____________ State___ Zip________
Employed by___________________ Address___________________
Number of hours to be taken weekly____
Class Lessons____ Private Lessons____ Semi Private Lessons____
Pre-School____ Pre-Ballet____ Ballet____ Pointe____ Character____
Jazz____ Tap____ Ballroom____ Trampoline & Gymnastics____
Salsa, Swing, Club Dancing, Freestyle, or Other__________________________
Class Description from Schedule_________________________________________________
Total Due Per Term: $______ for___ hours from _____ through _____ (EXPIRATION DATE)

CONDITIONS OF THIS AGREEMENT:
All tuition is payable in advance by the term.
Positively NO REFUNDS.
No term of lessons can be extended beyond the expiration date because of missed lessons for any reason.
Tuition paid toward the study of one type of dance may not be changed to apply in part or whole toward any other type of dance instruction.
All private lessons must be cancelled at least 8 hours in advance or they will be counted as taken.
You must notify the studio if you will miss a class lesson.
Depending upon enrollment needs, Nelson Dance Center reserves the right to add more classes, consolidate and/or combine classes, or to cancel, shorten the length of, or reschedule a class. Refunds for canceled or rescheduled classes shall be on a pro rata basis. No refunds or partial refunds will be given for consolidated or shorter length classes of small enrollment.

Signature_____________________________________ Date_________________

Copyright © 2003 Nelson Dance Center. All rights reserved.