Name *Student's D.O.B *Street Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaAustraliaArubaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCabo VerdeCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGuernseyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontserratMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSaint HelenaSaint Pierre & MiquelonSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUS Minor Outlying IslandsUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweParent or Guardian Email: *Phone *Emergency Contact:Terms & Conditions *I agree to the Terms & ConditionsI am committing to and/or committing my child to Fall/Spring or Summer semesters at Concordia Arts Academy. We will adhere to all rules/policies as listed on Concordia Arts Academy’s website. I will give my teacher a 60-day notice and the office manager a 60-day written notice if we choose to cancel lessons or classes. For private lessons if my student is 15 or more minutes late the teacher does not have to stay and will not give a make up lesson. For private lessons I understand we only get a make up lesson if we have a family emergency or the student is ill, sometimes this make up is in the form of a master class. For group classes there are no make up classes if we miss. I understand if I make a tuition payment past the 5th of the month, I will pay a $20 late fee, this includes if I did not update my expired or lost/stolen debit or credit card. I understand this is a “performance” based academy and will make every effort to have fore-mentioned student in at least 2 performances or more per year. I understand all costume fees will come out of my account if they are not all paid by February 1st. I understand that all costumes purchased are for the Spring shows and that class uniforms (with some adjustments) are used for the Winter showcases. Students in dance/aerial/tumble/musical theatre must be in class uniforms for all classes. I will provide a working email address and check my email regularly for updates and will check Concordia’s Facebook families page for updates on weather, class changes and announcements.Class:day/time/class nameClass:day/time/class nameClass:day/time/class nameSetup Monthly Autopay for Tuition Only *YesNoPermission to use photos of student in promotional content: *YesNoSignature *Start signing your signature hereYour browser does not support e-Signature field. Register