Rising Star Academy

Rising Star Schedule

MONDAY

TUMBLING FUNDAMENTALS
5pm – 6pm

RED ELITE
5pm – 6pm

BLACK ELITE
6pm – 7pm

DANCE SWAGG
6pm – 7pm

ADULT DANCE FIT (WALK-IN ONLY)
7pm – 8pm

TUMBLING FUNDAMENTALS
7pm – 8pm

JUMP DRILLS & CONDITIONING
7pm – 8pm

JAZZ FUSION
8pm – 9pm

TUESDAY

TINY TOTS TUMBLING
5pm – 5:45pm

SILVER ELITE
5pm – 6pm

HIP HOP RASCALS
6pm – 6:45pm

RED ELITE
6pm – 7pm

WEDNESDAY

GOLD ELITE
5pm – 6pm

FLIGHT TRAINING
6pm – 7pm

MAJORETTE 101
6pm – 7pm

ADULT DANCE FIT (WALK-IN ONLY)
7pm – 8pm

SILVER ELITE
7pm – 8pm

BALLET
8pm – 9pm

THURSDAY

TUMBLING FUNDAMENTALS
5pm – 6pm

SILVER ELITE
5pm – 6pm

GOLD ELITE
6pm – 7pm

DANCE FUSION
6pm – 7pm

FRIDAY

Reserved For Camps, Specialty Clinics, And Makeup Classes.

Register HERE

1Rising Star Academy Registration

2 Release of Liability & Waiver

3Tuition/Payment Policies

Parent Information

(if athlete is under 18)

Primary Parent/Guardian Name

First Last

Phone Number

Parent's Email

Secondary Parent/Guardian Name

First Last

Phone Number

Parent's Email

Emergency Contacts

The following named people are to be contacted should COA staff be unable to reach a parent/guardian named above, and shall be authorized to act on behalf of the parents/guardians in their absence:

Name*

First Last

Relationship To Athlete*

Phone*

Name*

First Last

Relationship To Athlete*

Phone*

Medical Information

To provide your athlete with a positive experience PLEASE disclose any known medical or mental conditions that may require our attention:

Allergies

Medications/Dosages

Athlete's Physician*

Phone*

Insurance Company*

Name Of Insured*

Policy #*

ID#*

Relationship To Athlete*

Athlete's Information

Athlete's Name*

First Last

Athlete's Date of Birth*

Month

Day

Year

Address*

Street Address City ZIP / Postal Code

Athlete's Gender*

Male

Female

Prefer Not To Answer

Other

Athlete's T-shirt Size*

Choose Your Package

Select a monthly class option of 1 class, 2 classes, or unlimited classes.

Annual Registration Fee*

Price:

Select Your Registration Option*

CLASS SELECTION*

Choose Only 1 of The Following

Tiny Tots Tumbling

Tumbling Fundamentals

Dance Swagg

Red Elite

Silver Elite

Gold Elite

Black Elite

Jump Drills & Conditioning

Hip Hop Rascals

Dance Fusion

Flight Training

Majorette 101

Tumbling Fundamentals

Jazz Fusion

Red Elite

Ballet

CLASS SELECTION*

Choose Only 2 of The Following

Tiny Tots Tumbling

Tumbling Fundamentals

Dance Swagg

Red Elite

Silver Elite

Gold Elite

Black Elite

Jump Drills & Conditioning

Hip Hop Rascals

Dance Fusion

Flight Training

Majorette 101

Tumbling Fundamentals

Jazz Fusion

Red Elite

Ballet

Medical Authorization and Liability Release*

I authorize COA Elite and its representatives to consent to medical treatment for my child when I cannot be reached to give consent. I am fully aware that any activity involving motion, height, or athletic exercise creates the possibility of serious injury, paralysis, or even death. I further agree to hold COA Elite and its staff harmless for any injury or resulting expense(s). I release and discharge all rights and claims against COA Elite, and its parties. COA Elite strives to provide the maximum in safety procedures and guidelines, and cannot assume responsibility for any accidents, injuries or illness that may occur.

Authorization to obtain medical treatment if necessary for athlete (18 or older) or authorization from parent or guardian if he/she is not available to make this decision (if under 18).*

I give FULL PERMISSION to COA Elite LLC, its Owner(s), Director(s), Staff, Employee(s), Independent Contractor(s), and/or Volunteers, the legal right to choose or decide what medical attention be provided, should the need arise, when the athlete(s) cannot make this decision (if under 18 years of age) or parent/guardian for the athlete(s) under 18 years of age is not present to make this decision.

Parent Consent*

The athlete listed above has my permission to participate in the COA Elite program and or camp for the 2021-2022 year. In consideration for the training and coaching provided by COA Elite and its staff, I understand that my son/ daughter must abide by the rules and regulations set forth by the coaches and staff. I understand that violations of any of these rules may result in removal from the classes and or events. We acknowledge and recognize that hazards are present in any athletic event and that injury may result. COA Elite coaches, staff and volunteers will not be liable for injury that occurs during cheerleading practice, contests, or travel to and from cheerleading activities.

Signature*

RECITAL FEE/COSTUME COSTS*

Rising Star Academy dance athletes will participate in an end of the year showcase/recital. A recital fee of $250 will be due January 1st.*

REQUEST TO CHANGE SCHEDULE OR OPT OUT*

Thirty (30) days written notice is required for all requested changes in schedule or if you would like to opt out of this Agreement. If no notice is provided, this Agreement will continue to be in effect and monthly charges still apply.*

REFUNDS*

There are NO REFUNDS for missed classes, changed schedules, recital fees, or termination of this agreement unless agreed upon by COA.*

COLLECTION OF PAST DUE ACCOUNTS*

Accounts that are thirty (30) days past due will be placed on pre-collection status. Once an account becomes sixty (60) days past due the outstanding balance will be sent to collections. COA may, in its discretion, retain a collection agency and/or attorney to collect past due balances. The Responsible Party understands and agrees they will assume all financial responsibility of COA’s collection costs to include fees paid to collection agencies and/or attorneys, whether or suit is brought or not, to include all pre/post collection/lawsuit costs.*

NON-DISCLOSURE AGREEMENT*

Athletes, family members or any other Representative agree not to disclose or reproduce any information regarding gym operations, choreography, staging, music, costumes/uniforms, designs, client lists, athlete information and/or family contact information. This information is the property of COA.*

RESPONSIBILITY AGREEMENT*

The Athlete, family member, or any other person associated with the Athlete, who enters gym or any other premises used by COA will be held responsible for any and all of their actions to include any or all damage to or loss of property belonging to COA, whether owned or rented, or any other person or party. The Responsible Party agrees to and will assume financial responsibility for the repair and/or replacement of any damaged and/or lost property of COA or any other party.*

COA’s RIGHT TO MAKE CHANGES*

COA reserves the right to make changes to class schedules, instructors, performances, company events, etc., at any time.*

All registered athletes are required to have a credit card on file. The credit card will be billed on the 1st of every month. To avoid charges to the credit card all invoices must be PAID IN FULL on the last business day PRIOR to the 1st of the month. A $35 late fee will be assessed and automatically charged to the Responsible Party if payment has not been received by 5 PM on the 5th of each month. If payment has not been received by the 15th of each month, the athlete will not be able to attend class until tuition and the late fee has been paid.
**If there is a waiting list for the enrolled class your athlete will be bumped at the end of the month if tuition remains unpaid. All past due fees are still due to COA. **

Consent*

I, the Athlete (if 18 or older), or Parent/Guardian (for athletes under 18 years of age) have filled out this form accurately. I have read, understand, and fully accept all sections, terms, and conditions of this Agreement.*

Signature*

Payment Information

Total

Consent*

I understand and authorize COA to charge my credit card for my monthly tuition payment and/or other fees such as late charges and/or annual registration costs. All payments are due on the 1st of every month. If my monthly tuition has not been received by the deadline (described above), I authorize COA to charge the monthly tuition and late fee to my credit card processing fee.

Credit Card*

**A 3% credit card processing fee is added to each credit card transaction. **

Card Details

Cardholder Name

Fitness. Friendship. Fun.

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