Student Name *

First Name

Last Name

Parent 1 Name *

First Name

Last Name

KDA Liability Waiver and Talent Release *

https://static1.squarespace.com/static/589df1e3b8a79b0381121e72/t/5ad3c44188251b90ed558033/1523827777916/Liability+Waiver+2018.pdf

By checking this box, I am electronically signing that I have READ, UNDERSTAND AND AGREE TO Kailua Dance Academy's LIABILITY WAIVER AND TALENT RELEASE

KDA Studio Policies *

https://static1.squarespace.com/static/589df1e3b8a79b0381121e72/t/65f1f8adc214e764755984c0/1710356654304/KDA+STUDIO+POLICIES+2024+Update.pdf

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO Kailua Dance Academy's STUDIO POLICIES

KDA Studio Policies: TUITION *

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO Kailua Dance Academy's TUITION POLICIES

KDA Studio Policies: ATTENDANCE *

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO Kailua Dance Academy's ATTENDANCE POLICIES

Studio Policies: MAKEUP CLASSES *

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO Kailua Dance Academy's MAKEUP CLASS POLICIES

Studio Policies: PERFORMANCE *

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO Kailua Dance Academy's PERFORMANCE POLICIES

Studio Policies: COMMITMENT *

By checking this box, I am electronically signing that I have READ, UNDERSTAND, AND AGREE TO Kailua Dance Academy's COMMITMENT POLICIES

Tuition: Please select how you would like to pay tuition this year: *

In Full (includes 10% discount, due AUGUST 1, 2025)

Semester (2 payments due Aug 1 and Jan 1)

Quarter (4 payments due Aug 1, Oct 1, Jan 1, March 1)

Bi-Monthly (5 payments due Aug 1, Oct 1, Dec 1, Feb 1, April 1)

Monthly (10 payments due Aug 1, Sept 1, Oct 1, Nov 1, Dec 1, Jan 1, March 1, April 1, May 1)

For Dance With Me ONLY: 10 Class Card

FOR THOSE SIGNING UP FOR A PAYMENT PLAN:

Please select

I WOULD LIKE to be enrolled in auto-pay. I am electing to have my credit card automatically charged for tuition payments for the school year.

I would NOT like to be enrolled in auto-pay, and will be responsible for making my tuition payments on time. UNPAID TUITION MAY RESULT IN DISMISSAL FROM THE SCHOOL

Tuition Discounts: Please check all that apply

Full Tuition Discount (10% off): I would like to pay tuition for the 2025-2026 School Year by August 1.

Multi-Class Discount (5% off): I am registering siblings OR I have a dancer signing up for more than one class

Dance With Me Sibling (20% off): I am registering two or more siblings for Dance With Me. CANNOT BE COMBINED WITH THE MULTICLASS DISCOUNT

Please update any changes to current student information below:

No changes

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent 1 Primary Phone

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Parent 1 Secondary Phone

(###)

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Parent 2 Name

First Name

Last Name

Parent 2 Primary Phone

(###)

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Parent 2 Secondary Phone

(###)

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Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

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