* Indicates required fields. Please fill out form as completely as possible.
Family Account Info
My family is a (check one)*:
New client
Returning client
Mom's/Guardian's Name*
Dad's Name
Address*
City, Zip Code*
Home Phone
 Cell Phone*
Best time of day to call you
Email*
Confirm Email
Please re-type your email address.
How did you hear about Footsteps?
Referred by:
If a friend or neighbor referred you, please tell us who
so we can thank them with a referral credit!
Event:
If you learned of us at an event or public performance,
please tell us where.
Female
 Male
Dancer #1 name
Age as of Oct 1, 2011*
Birth Date* (mm/dd/yy)
Medical/developmental conditions
that may affect dancing:
Please indicate your 1st and 2nd choices of days/times for each class in which
you wish to enroll each dancer. You will get your 1st choice unless that class is
full; you will receive a confirmation email detailing your finalized class schedule.
Desired class title*:
Example: Genesis 5/6 Ballet
1st choice day & time*:
Example: Thursday 4:15-5:00
2nd choice day & time:
Desired class title:
1st choice day & time:
2nd choice day & time:
Desired class title:
1st choice day & time:
2nd choice day & time:
Dancer #2 name
 Female
 Male
Age as of Oct 1, 2011
Birth Date (mm/dd/yy)
Medical/developmental conditions
that may affect dancing:
Desired class title:
1st choice day & time:
2nd choice day & time:
Desired class title:
1st choice day & time:
2nd choice day & time:
Desired class title:
1st choice day & time:
2nd choice day & time:
Female
 Male
Dancer #3 name
Birth Date (mm/dd/yy)
Age as of Oct 1, 2011
Medical/developmental conditions
that may affect dancing:
Desired class title:
1st choice day & time:
2nd choice day & time:
Desired class title:
1st choice day & time:
2nd choice day & time:
Desired class title:
1st choice day & time:
2nd choice day & time:
Payment Options
Emergency Contact Info
Please select one payment plan. You will
receive an email with your tuition total and
registration fee, as well as payment
instructions.
Info should be for someone other than a
parent--of course, we would call a parent
first if there were a medical emergency!
Monthly (Yearly amount
divided into 9 monthly
installments). Payments
are a flat rate regardless
of the number of classes
scheduled in any given
month.
Contact Person*:
Relationship
to dancer(s)*:
Contact Phone*:
Please include area code.
Trimester (3 months at a
time, 3% discount applies.
Yearly amount divided into
3 installments.) Payments
are a flat rate regardless
of teh number of classes
scheduled in any given
trimester.
Yearly (9 months at a
time, 5% discount applies)
Permissions/Terms
The instructors at Footsteps Family Dance Center, LLC, are safety-conscious, however, I
(parent/guardian) understand that because dance is a physical activity, injuries minor and major are
possible for my dancer despite all safety precautions. I, intending to be legally bound, waive and
release Footsteps Family Dance Center, LLC, its members, instructors, staff, contractors, and
volunteers of any and all responsibility for injury or illness. In the event of an injury or illness, I
understand that every effort will be made by the FFDC staff to contact parents/guardians first; if a
parent/guardian is unreachable, the emergency contact person I have provided will be contacted and
has my permission to authorize medical treatment for my student(s). If necessary, I authorize
Footsteps Family Dance Center, LLC, to administer any minor first aid and/or authorize medical
treatment. The above-named student(s) has had a medical examination within the last 12 months and
is capable of participating in dance.

A copy of the Studio Policies will be provided to me at the commencement of the 2010-11 fall season,
or sooner upon request. I agree to read and abide by the Policies mentioned therein.

I hereby give Footsteps Family Dance Center, LLC, permission to use my child's photos and/or
videos in the studio, in printed materials, and online for marketing and promotional purposes. I
understand that my child's name and contact information will not be published with photos/videos for
security reasons.
I accept these terms.
Terms must be accepted
in order to enroll.
I do not accept these terms.
This form is for registration for our Fall 2011-12 Dance Season, September
2011-June 2012. Early-Bird Fall Registration end July 18, 2011. Regular Fall
Registration continues indefinitely.

If you would like to register for summer, please go to our Summer Online
Registration page.

If you are simply looking for information about our classes, please use our
Contact Us page.

Online registration is a 3-step process that offers families the convenience of not
having to leave home to join the fun at FFDC. Filling out this online form is Step
1. This online registration form will put your dancer(s) in queue for admission into
the classes you select below.

In Step 2, you will receive an email confirming that we have received your online
form, verifying the classes in which your dancers are queued, and providing you
with a total due, additional forms (if applicable) attached, and payment
instructions.

Step 3 is the submission of payments and additional forms (if applicable).
Registration is not complete (i.e. dancers are not enrolled) until the
registration fee ($25/single student or $35/family), first month's tuition, and
late payment form (if applicable) have been received by our office.

For general info about tuition, please refer to our About Us page, under How
Much We Charge. Please feel free to call our office at 614-883-5599, and our
staff will assist you with tuition estimates for your family.

Please be sure to provide a valid email address below. We'll be happy to
welcome you into the Footsteps family as soon as all of your paperwork has been
taken care of!
Footsteps Family Dance Center Online
Registration Process