Company Audition Info Request - Balance Dance Studios | Dance Classes | Adults

Student's First Name*

Student's Last Name*

Student's Age

Please provide the instructor's name and class you are dropping in the space below (if dropping more than one class, please list them with the instructors' names):*

Please provide the reason you are leaving in the space below.*

How long has your dancer been enrolled at Balance?*

How would you rate the value of our dance education in relation to our tuition rates? *

Excellent

Satisfactory

Needs Improvement

If considering dance in the future, would you return to or recommend our studio? *

Yes

Your Name

Your Email*

Please include any additional comments/feedback/suggestions you wish to share in the space below.

Please read the studio withdraw policies and sign below:

Policies:

-If request is not received at least 7 days before the 1st of the month, then the normal tuition draft will be processed without a refund.

-No prorated tuition refunds will be issued if choosing to withdraw prior to the end of the month.

-No refund for any performance or studio fees (including costume fees) will be processed for any reason whatsoever. If a costume has not been received, then it will be available for pickup upon arrival.

I am choosing to withdraw my dancer from Balance Dance Studios. I agree to pay any remaining balance on my account before fully withdrawing. If I have not paid the account balance after the last class, I give permission to Balance Dance Studios to charge the balance without preapproval as stated in my registration agreement. I acknowledge that if for some reason, the balance is uncollectible, it will be sent to a third party collection agency with additional penalty fees. I have read and fully understand this form and agree to all of Balance Dance Studios withdraw policies.

Please type your name in the space provided to agree to the terms above: