Jeune Attente Dance Company Class Registration

September 2013-April 2014

Jeune Attente Dance Company classes are officially sponsored by the Fine Arts Department of the Dysart Womens Club. Classes will be held on Saturdays beginning September 7, 2013 at the Dysart Community Building, except for selected Saturdays when classes will be held at Union Middle School in Dysart. Classes are offered for 4-year-olds (must be age 4 by November 1, 2013) through high school. Students study ballet, tap, jazz and clog, depending on their class level. Monthly dance fees are as follows: Level 1(30 minutes): $16.00; Levels 2-5 (50 minutes): $25.00; and Levels 6 & 7 (80 minutes): $32.00.

Dancers Name:________________________________Age (by Nov. 2013)_____Grade (Fall 2013)________ Mailing Address________________________________________E-mail Address________________________ City__________________Zip___________Phone_______________________Cell ______________________ Parent/Guardian Name(s):___________________________________________________________________ Address and Phone (if different than dancers) _____________________________________________________ New to Jeune Attente Dance Company? YES NO If new, previous dance experience: _____________________________________________________________ Medical conditions the instructor should be aware of: ______________________________________________

Registration Fees (Costume down-payment) Your child will be considered registered and a spot will be held for him/her once the costume fee has been paid. Registrations must be postmarked or received by June 15, 2013. A $10 late fee will be added for registrations postmarked or received after June 15, 2013. Please make checks or money orders payable to JADCO for the amount below:
Preschool 5th Grade: Registrations received/postmarked by June 15, 2013: $40.00 each dancer Registrations received/postmarked after June 15, 2013 $50.00 each dancer 6th Grade High School: Registrations received/postmarked by June 15, 2013: $60.00 each dancer Registrations received/postmarked after June 15, 2013: $70.00 each dancer __________ __________ __________ __________

*Your costume fee is non-refundable after September 30, 2013. Class times will be assigned following the registration deadline. You will receive a mailing that will state your class level and dance fees along with further information. Your registration fee doesnt include any part of your tuition. I will not hold the Fine Arts Department, the Dysart Womens Club, the instructors, or any member of the Jeune Attente Dance Company parent board responsible in case of accidents or injuries that occur during dance class.

Choose 1: I plan to make payments for dance monthly _______ semi-annually________yearly_______ I will/ will not allow my childs picture to be posted in the newspaper or on a JADCO internet site. Signature of parent/guardian__________________________________________Date______________
Please complete this form and attach your payment. Mail to Cathy Niebergall, 1234 Lakeview Dr., Buckingham, IA 50612. Questions? Call Cathy Niebergall at (319) 476-5141.