Farmington School of Dance
Please complete ONE form per person. Be sure to press
SUBMIT at the bottom of this page when you are finished.

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If you have taken at another studio, please select all the forms of dance you have studied.
How did you find out about us? (Check all that apply.) *

In case of medical emergency, I understand that when medically feasible, an effort will be made to contact a family member or emergency contact, but in the event one is not reached or it is not medically feasible to contact one, I hereby give permission to be treated. Furthermore, I agree to hold harmless Farmington School of Dance and all of their employees and agents in the event of an injury occurring during any activities associated with the Farmington School of Dance. I recognize that participating in this activity has a certain amount of risk and that an injury is always possible. I certify that I am, to the best of my knowledge, physically able to participate in this activity. I assume full financial responsibility for medical expenses arising out of such injury.

I also allow all pictures and film taken to be used for publicity purposes for the Farmington School of Dance. I hereby indemnify and hold harmless against any and all claims of damages arising out of taking or use of pictures or videos.

I agree that I will abide by the standards set by this studio in the studio handbook. By signing this registration form, I assume full financial responsibility for all fees, including but not limited to tuition, shoes, costumes or recital fees.

Submitting this form indicates that you understand you are responsible for monthly tuition of $40 per month.  If you have a child dancing, you are eligible for a $5 family discount!

You may print this form and drop your registration form & payment in our mailbox at 18 S. Jackson St. in Farmington or mail your form to:

Farmington School of Dance
Sue Savage
546 Dorothy St.
Farmington, MO 63640

Scroll down to the bottom of the page to submit this form.
All fields marked with * must be completed in order to submit.

Please call or email with additional questions or to request a paper registration form.
Or return to our homepage for additional information.

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