New Students Previous Training? Please list previous experience in dance/ theatre. Attach another sheet if needed

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1 Reg. Pd. Tuition Pd. Signed/Initialed 2 Canton Street, Suite A-8 Stoughton, Massachusetts REGISTRATION FORM Student Name (first & last) Age: & DOB Home Address City/State/ZIP Home Phone Cell Phone (where the student will receive correspondence) Name of Contact Parent/Guardian Phone Number (if different than listed above) Emergency Contact Phone Number Please List Medical History/ Injuries/ Allergies that The Conservatory School for the Performing Arts, LLC should be aware of. Restrictions with Physical Activity? Please Circle Yes No If yes please explain: Attach another sheet if needed New Students Previous Training? Please list previous experience in dance/ theatre. Attach another sheet if needed I understand and will adhere to CSPA s makeup & hair guidelines for any performance event(s) X Parent/Guardian Signature (first, last name) X Date

2 I am Registering for: (check all that apply) Dance Department Preschool Program (ages 3-5) Broadway Babes Como Dance (ballet/jazz/tap ages 5-7) Creative Movement (ages 3-5) Recreational Dance Program (ages 7-18) (Circle) Ballet Jazz Tap Contemp/Lyrical Acrobatics Hip-Hop Ballet, Tap, Jazz Combination Dance beg/int Musical Theatre Department Broadway Babes vocal/acting (ages 5-7) ShowBiz Kids vocal/acting (ages 8-10) Touring Company (ages 10-12) On Broadway (ages 13+) Acting (ages 7-10 ) Acting (ages 11+) Modeling Program Modeling/ Pageantry Program Private Lessons Voice (circle) 1/2 hr 45mins 1 hr 1.5 hrs Dance (circle) 1/2 hr 45 mins 1 hr 1.5 hrs Acting (circle) 1/2 hr 45mins 1hr 1.5hrs Modeling/Pageantry (circle) 1/2hr 45mins 1 hr 1.5hrs 6 or 8 Week Program Mommy & Me Sing Along Creative Music Glee Club College Prep Registration Check List Signed Registration Form $25 Non Refundable Registration Fee (New Students) $15 Non Refundable Registration Fee (Returning Students) Registration Form & Waiver Tuition (Cash/Check/Money Order) How Did You Hear of Us? (circle) Website Flyer Performance Word of Mouth Returning Student Other Promotions: Free registration for all returning students. Valid until August 23, 2018 Refer a Friend: Receive $10 off your tuition when you refer a friend. $20 off when you refer 2 or more students Family Discount: $10 off tuition 2 siblings. $15 off 3 siblings, $20 off 4 or more siblings. $10% off registration fees for families.

3 The Conservatory School for the Performing Arts, LLC Release and Waiver Liability, Assumption of Risk, and Indemnity Agreement REGISTRATION IS INCOMPLETE WITHOUT SIGNATURE AND MUST BE COMPLETED BEFORE THE FIRST CLASS I understand and agree that in participating in any classes, programs, workshops, camps, events, or activities there is a possibility of physical illness, bodily injury, disability, paralysis, or death. I voluntarily agree, therefore, to assume all risks and responsibility for any such injury or accident, which might occur to me or my child during any of The Conservatory School for the Performing Arts, LLC classes, programs, workshops, camps, events, or activities. I also exempt, release, and indemnify The Conservatory School for the Performing Arts, LLC, its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students from any and all liability claims, demands, or causes of action whatsoever from any damage, loss, injury, or death to me, my children, or property which may arise out of or in connection with participation in any classes or activities conducted by The Conservatory School for the Performing Arts, LLC. I further hereby voluntarily agree to waive my rights and that of my heirs and assigns to hold The Conservatory School for the Performing Arts, LLC its owners, agents, volunteers, assistants, employees, guest artists, faculty members, and/or students liable for such damage, loss, injury, or death. I understand that I should be aware of my physical limitations and agree not to exceed them. If I am signing this waiver for my children, I certify that I am the parent or legal guardian and have the right to waive these rights. Permission is granted to The Conservatory School of Performing Arts, LLC to use photographs and videos of students for publicity purposes. Undersigned hereby warrants that prospective student for whom this registration application is submitted has only the following physical limitations, impairments or conditions: (Only write word "None" on above line if there are absolutely no such conditions) I have read, understood and agree to be bound by the above statement (please print your name, sign & date): PRINTED: SIGNED: If under 18, parents or legal guardian must sign FOR: Name of Student DATED:

4 THE CONSERVATORY SCHOOL FOR THE PERFORMING ARTS, LLC PAYMENT TERM AGREEMENT Student s Name (first & last) Parent/Guardians Name (If under 18) Phone: Tuition Payment Policy Agreement I, understand that all tuition and costume fees are non refundable and non transferable. I understand that there are no refunds or credit adjustments due to absences, holidays, cancelations to weather, school vacations, expulsion or suspension. I understand that all tuition balances must be paid by the 1st of the month or a $25 late fee will be applied. I understand that all returned checks will incur a $50.00 fee, and declined charges will incur a $25.00 fee. A $25.00 withdrawal fee will be automatically charged to my card on file for withdrawals after October 1, I understand that my child will not be allowed to attend classes after 14 days of delinquency. I understand that in order for my child to perform in The Conservatory School for the Performing Arts, LLC annual Showcase I must make full payment (cash/credit/debit only) to any outstanding balances 7 days prior to the show. I understand that a $ Showcase withdrawal fee will be automatically charged to my card on file for Showcase withdrawal after April 1, I understand that my card on file will be automatically charged the withdrawal fee and/or the Showcase withdrawal fee for 30 days of no show to classes and/or 30 days of failure of notification of withdrawal. If my child does not show up for the spring Showcase I fully understand that my card on file will be automatically charged the Showcase withdrawal fee. X (First & Last Name) X (Signature) X (Date) X (Date)

5 Monthly Payment Options. Option 1: Automatic Payment Plan (credit or debit) X Written notice must be given by the 20th of the month, or the following month s tuition will be charged. X Declined Charges will incur a $25.00 fee. X Option 2: Pay by the 1st of every month by cash/check/credit/debit This option must be secured with a major credit card on file (fill out credit card information below) I fully understand that if tuition is not received by the 30th of the month my secured card on file will be charged the balance due for the month X Option 3: Pay Tuition in full for the Year (September 2018-June 2019) Receive 10% off, if the year is paid in full by August 23rd, 2018 & 5% off if the year is paid in full by September 1st, 2018 X Registration Fee Annual Non-Refundable Registration Fee of $25.00 for new students due at the time of registration. $15 Non-Refundable Registration Fee for returning students after August 23, X Registration fee secures the student s spot in class and covers administration fees Tuition is due at the time of registration X Private Lessons Must be paid in monthly payments or in full (September 2018-June 2019.) 48 hour Cancelation Policy: Private lessons must be canceled at least 48hrs before the scheduled lesson. You will be charged for the lesson if 48 hour notice is not given. There are no refunds for missed lessons due to weather cancelations, school vacations, holidays, absences, expulsion or suspension. Makeup lessons may be made up in a similar class if available X Costume Fees All costumes are $85 per costume, and will be due in two installments during the months of October and November. Costumes include tights and accessories. Costumes can be paid by cash/credit/debit/check. Any outstanding costume balances by December 1 will be charged on the secured card on file. X Fill Out Credit Card Information Here: Credit Card (circle): Master Card Visa Discover Amex CC# CCV2# (3 numbers on the back) Expiration Date: Name on Card: Address for Credit Receipts Only Billing Address of Cardholder