SummerArts 2008
Registration Form
Name of Parent
or Guardian:
Phone #
Address:
Email:
Student Name:
Date of Birth:
Student Address:
Referred by:
_______________________________________________________________________________________
DAYTIME SCHEDULE
Week 6 - July 28-Aug 1
DANCE
Peach Festival Show Corp
_______________________________________________________________________________________
Total Amount Due (Please
include $25 Registration
Fee if applicable. Students
enrolled in classes during
the 07-08 seasons do not
pay a registration fee.)
Credit Card #:
Exp. Date:
Credit Card Identification Data (CID #) - 3 or 4
digit code on back of card in the signature panel
Yes, I would like to be set up on a payment plans.
Additional Comments:
By checking the boxes below and entering your name in the "signature" box, you are
indicating in writing your agreement with the terms and conditions of this enrollment.  
Thank you!
I hereby accept all responsibility for any accident, injury, or illness that may occur in
conjunction with this program.  I am releasing and hold harmless Premier Centre for the
Arts and all other parties involved from any and all claims, costs, liabilities and expenses
including all judgments, attorney’s fees and court costs.  I understand that Premier Centre
for the Arts provides no medical insurance for the participants. I am executing this waiver
and release for my child/me to participate in this program.  I have read and agree to all
terms listed in this catalog.  
I understand that from time to time, PCA will photograph events and classes for
promotional purposes.  I give PCA permission to use my/my child’s image and name for
promotional purposes.  
I understand that there are no refunds or credits for tuition.
I understand that there is absolutely no video recording or photography permitted at any
PCA performance.  Failure to comply with this policy will result in ejection from the
event without a refund.
I understand that PCA reserves the right to transfer a student to another class or to
dismiss a student for poor progress and/or attendance or failure to comply with PCA
policies.
I understand that recital participation is a requirement of PCA programs.  Students not
participating in recitals will not be permitted to register for future classes.
Parent / Guardian
"Signature"
If you have any questions or comments, please email here.