Ballroom Registration

Student Information

Student Name*

First Last

Gender*

Lady

Man

Grade Level Fall 2023*

Which elementary are you attending 2023-24?*

Northridge

Orchard

Rocky Mountain

Lindon

Windsor

Other

Share your info for carpooling?

Students and their parents are responsible for obtaining transportation to Northridge for class.

Will you allow Ms. Michelle to share your contact with other parents who are attempting to arrange carpools and rides?

Student Birthday*

MM slash DD slash YYYY

Student School Email*

(example: something@alpinesd.org)

Guardian/Parent Name 1*

First Last

Guardian/Parent 1 Phone*

Guardian/Parent 1 Email*

We will communicate weekly by email, to save on copy costs.

Guardian/Parent Name 2

First Last

Guardian/Parent 2 Phone

Guardian/Parent 2 Email

Other Guardian/Parent?

Yes

Guardian/Parent 3*

First Last

Guardian/Parent 3 Phone*

Guardian/Parent 3 Email*

Another Guardian/Parent?

Yes

Guardian/Parent 4*

First Last

Guardian/Parent 4 Phone*

Guardian/Parent 4 Email*

On Ballroom Team last year?*

Yes

Class Options

Based on grade/age and/or previous experience, below are the class options. 4th grade may choose between 1 or 2 day.

1 Day -	3rd & 4th grades 4th grade is encouraged to select 2 Day if possible
2 Days -	4th, 5th & 6th grades

Available Classes:

1 Day (3rd & 4th grades)

$100/year
(For 4th graders, we recommend the 2 day)

Tuesdays (3:35 - 4:35 pm)

2 Days (4th, 5th, & 6th grades)

$200/year

Tuesdays & Thursdays (3:35 - 4:35 pm)

More Student/Guardian Info

Are you as parent/guardian willing to use the Remind app?*

Yes

If your student is a lady, and convinced a man to signup as well, enter his name:

Check all other extra-curricular commitments

Chorus

Orchestra

Drama

Art Club

Other

Other activity*

Any Ballroom dance experience?*

Yes

(If not, no problem!)

Where and when?*

Other dance experience?*

Yes

(It's ok to say no)

What kind and how long?*

What/who inspired your student to join Ballroom?

Check any that apply

Friend

Sibling

Ballroom Team Member

Ballroom Assembly

Northridge Lunch-time Video

Northridge Lunch-time Dancers

Back -to-School Night

Cool posters in the halls

Loved being on Team Last year!

Principal's email

Other

Other inspiration*

I understand:*

(Check each box to show you understand and agree to each condition)

Ballroom classes are held at Northridge Elementary.

the class fee is $100/$200 per student per YEAR. Payment is due the 1st day of class.

if student fees are not paid by 2 weeks after Ballroom starts, my student may be removed from the class.

refunds are not available for elective withdrawal after the program has been running for 2 weeks.

the ballroom program is a girl and boy activity. Only so many more girls than boys (as determined by teacher) may be accepted to ensure a quality ballroom dance experience for all participating students.

that if the class is already full of girls, then my girl’s name will be placed on a “girls waiting list” until a boy commits to join the class.

that if a girl recruits a boy to join the class, she may add the class immediately (if there is room for them) and the boy commits to year in the program.

that enrollment interest will determine if class(es) carry.

the ballroom class enrollment for new team members is based on a first come first serve basis.

the ballroom program is a year-long commitment (September to April).

if the student misses too many practices they may not perform or compete, and may be removed from the team if the problem continues.

that I may be asked to help in some way to assist the program (ie: donations, class treats, Team Match, Concert, etc).

some Ballroom gear (shoes, clothing, etc) is required.

the student should have their own desire to participate in Ballroom. Parents/guardians should not force their child to join.

students will participate in assemblies, performances, and competitions with their team. Students do not choose the events in which they will participate.

Parent e-signature*

I have read, accepted, and discussed the Elementary Ballroom Standards with my student. My student agrees to follow the Ballroom Standards. I have also read the Frequently Asked Questions.

Student e-signature*

I agree to follow the Ballroom Standards.

Name

This field is for validation purposes and should be left unchanged.

2023-24 Ballroom Registration

Student Information

Class Options

More Student/Guardian Info