DTH Summer Intensive Registration Packet 2016

DANCE THEATRE OF HARLEM SCHOOL
REGISTRATION APPLICATION
Summer Session 2016
Status:  New Student  Returning Student  F-1 Visa
Date: ____________________
STUDENT INFORMATION: (please print)
Student’s Name: (Last)
___________________________
(Middle)
(First)
____________________________
Student’s Home Address:
_____________________________________________________________________________________________________
City
State
Zip Code
Best Phone Contact #
Date of Birth ________ Age ______  Male  Female  E-MAIL: _____________________________________________
Country of Birth __________________ Ethnicity ________________________________Citizenship Status _______________
Current Academic School:
Current Dance School_______________________________
Student’s NYC Address (if different from above)_______________________________________________________________
Parent/Guardian Information (please print)
__________________________________________
Parent/Guardian First and Last Name
_____
Parent/Guardian Address
________________________________
Parent/Guardian Place of Business
___________________
Relationship to Student
___________________________
Telephone Number
_____________________ ________ _____________________________
City & State
Zip Code
E-mail (Required)
_________________________
Work Phone
Household income range: None $5,000-$19,999 $20,000-$40,999
___________
Emergency Contact First and Last Name
_________________________
Position
$50,000-70,999
___________________
Relationship to Student
$80,000-$100,000+
______________________ _______________
Phone #1
Phone #2
Where did you hear about our school?  Reputation  Media  Recruitment  Word of mouth  Family Member 
___________________________________________________
Parent/Guardian Signature or Student’s Signature (if over 18)
LEVEL:
______________________________
Date
For Dance Theatre of Harlem School Use ONLY-DO NOt write below this line.
NY Session 1  Beginner 1
NY Session 2  Intermediate 1
 Beginner 2
 Intermediate 1
 Intermediate 2
 Intermediate 2
 Intermediate 3
 Advanced
466 West 152nd Street, New York, NY 10031-Phone: 212.690.2800-Facsimile: 212.690.8736
Website: www.dancetheatreofharlem.org
DANCE THEATRE OF HARLEM SCHOOL
APLICACIÓN PARA REGISTRACIÓN
Sesión de Verano 2016
Estatus:  Alumno Nuevo
 Alumno Pre-existente  F-1 Visa
Fecha: _________________
INFORMACIÓN DEL ALUMNO: (favor de usar letra molde)
Nombre del alumno: (Apellido)
______________________
(Segundo Nombre)
(Primer Nombre)
_____________________________________________________________________________________________________
Domicilio local del alumno
_____________________________________________________________________________________________________
Ciudad
Estado
Código postal
Teléfono de Casa
Fecha de Nacimiento_____________ Edad_______ Hombre Mujer  E-MAIL: ________________________________
País de Origen________________________ Etnicidad__________________________ Estatus de Ciudadanía_____________
Escuela Académica Actual: __________________________________Escuela de Danza actual__________________________
Domicilio de NYC del alumno (si es diferente de arriba) _________________________________________________________
Información de los Padres o Tutor: (favor de usar letra molde)
___
Padres/Tutor Primer Nombre y Apellido
___________________________________
Padres/Tutor Domicilio
___________________________________
Padres/Tutor lugar de trabajo
___________________
Relación con el alumno
______________
Ciudad Y Estado
Contacto de emergencia nombre
_________
___________
Código Postal
___________________
Teléfono Casa
Ingreso de los hogares:  Ninguno  $5,000-$19,999
___________________
Teléfono
__________________
Teléfono Móvil
_______________________________
El Email (necesario)
_______________
Teléfono Móvil
_______________________
Posición
 $20,000-$40,999  $50,000-$70,999  $80,000-$100,000+
___________________
Relación con el alumno
_____________________
Teléfono #1
__________________
Teléfono #2
¿Cómo se entero de nuestra escuela?  Reputación  Medios de Noticias  Reclutamiento  Familia  Otro _________
_____________________________________________________________
Firma del Guardián/Tutor Principal o Alumno (si mayor de 18)
LEVEL:
_________________________
Fecha
Para el uso de Dance Theatre of Harlem unicamente-Favor de no escribir despues de esta linea
NY Session 1  Beginner 1
NY Session 2  Intermediate 1
 Beginner 2
 Intermediate 1
 Intermediate 2
 Intermediate 2
 Intermediate 3
 Advanced
466 West 152nd Street, New York, NY 10031-Phone: 212.690.2800-Facsimile: 212.690.8736
Website: www.dancetheatreofharlem.org
DANCE THEATRE OF HARLEM SCHOOL
Doctors’ Health Statement (page 1)
Parents please note students are required as part of their registration to undergo a physical every calendar year.
Date of Examination: _____________________
____________________________________________________________________
Last Name,
First Name
Initial
Sex:
Address: __________________________________________
Age: _______
_____________________________________________________
City,
State
Zip Code
DOB: ____________
 F
 M
Telephone: _______________________________________
PARENTS: A HEALTH STATEMENT IS NOT VALID WITHOUT A PARENT/GUARDIAN SIGNATURE
After examination by a physician, the results of which appear on the following page, I believe my child to be
in proper physical condition for participation in the dance program at the Dance Theatre of Harlem School.
_____________________________________________
Signature of Parent/Guardian
________________________
Date
I hereby authorized Dance Theatre of Harlem School to provide emergency care as needed to my child
including but not limited to emergency room care. I understand that Dance Theatre of Harlem School is not
responsible for payment of hospital services rendered.
________________________________________________________
Signature of Parent/Guardian
______________________________
Date
THE FOLLOWING MUST BE COMPLETED BY THE EXAMINING PHYSICIAN ONLY
I understand that my patient wishes to enroll in the dance school referenced above, a program which may involve
strenuous exercise. After an examination, the results of which appear on the following page, I find no systemic,
neurological, orthopedic and/or cardio-vascular medical condition(s), which would prevent participation in the dance
program at the Dance Theatre of Harlem School.
__________________________________________________________________________________________________
Physicians name and address (Please type or print legibly)
__________________________________________________________________________________________________
City
State
Zip Code
Telephone number
_________________________________________ ____________________________________________________
PHYSICIAN’S SIGNATURE & OFFICIAL STAMP
Physician License Number
466 West 152 Street, NY, NY 10031-1814 Tel:212.690.2800 FAX:212.690.8736 www.dancetheatreofharlem.org
Doctor’s Health Statement (page 2)
Date of Examination: _________________________
Record of Physician’s Examination for __________________________________________________________
Last Name,
First Name
Initial
Does the patient require any of the following:
Eyeglasses:  Yes  No
Hearing Aid:  Yes  No
Other support device:  Yes  No
* REVIEW OF SYSTEMS *

Allergies:

Head & Eyes:

Ears, Nose, Throat & Mouth:

Cardiovascular:

Respiratory:

Gastro-Intestinal:

Genitourinary & Gynecological:

Neurological:

Skin & Endocrine:

Muscular-Skeletal:

Infectious:
Is the patient currently under treatment? If yes, please explain
________________________________________________________________________________________________________________________________________
__________________________________________
_________________________________________________________________________________________
Does patient take any medications?  No  Yes, please provide frequency and condition below
________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
Are the patients’ immunizations up to date?  No, please explain below  Yes, please provide a copy of the Record
of Immunizations along with this form.
________________________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________________
466 West 152 Street, NY, NY 10031-1814 Tel:212.690.2800 FAX:212.690.8736 www.dancetheatreofharlem.org
DANCE THEATRE OF HARLEM SCHOOL
MEDICAL HISTORY
Parents (to be completed by student if over 18) are required to answer ALL questions on this form.
If the question does not apply write N/A in the space provided.
PLEASE PRINT CLEARLY
Date: _______________________________
Student Name: ___________________________________
LAST NAME
___________________________________
FIRST NAME
Please list any allergies (food, medication etc.)
____________________________________________________________________________________________
____________________________________________________________________________________________
___________________________________________________________________________________________
Please identify any medical conditions. (If you check a condition please provide detail below)
 Asthma
 Diabetes
 ADD
 Scoliosis
 ADHD  Seizures
 Mental/Emotional Disorder or Imbalance
 Speech/Hearing Challenges  Muscular Injury (provide details below)
 Previous bone injury (Give details)
 Other (Give details):
_______________________________________________________________________________
_____________________________________________________________________________
____________________________________________________________________________
Any prescribed medications currently taken? If so, please provide name, dose and frequency below:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Please list any recent injuries that the student may be recovering from, or old injuries that may impact study:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Form completed by:  Parent
Print Name: ______________________________
 Student
Signature: _____________________________Date:___________
DANCE THEATRE of HARLEM SCHOOL (DTHS)
RULES AND REGULATIONS
SUMMER INTENSIVE SESSION 2016
The Rules and Regulations are in place to support the Dance Theatre of Harlem School’s (DTHS) mission to provide training in
the art of classical ballet and the allied arts within a safe, nurturing, learning environment for all students. Any student
who engages in inappropriate conduct or violates the Rules and Regulations of the Dance Theatre of Harlem
School may be expelled.
DANCE THEATRE OF HARLEM SCHOOL IS ACCREDITED BY: THE NATIONAL ASSOCIATION OF SCHOOLS OF DANCE.
In the interest of the overall security of our students and building and in keeping with the
building/fire/insurance codes, we respectfully ask that you follow the guidelines listed below:
STUDENT DEPORTMENT/ ATTENDANCE / COURSEWORK / EVALUATIONS:

Students are required to: 1. be on time, 2. to attend classes daily Mon.-Fri. and maintain satisfactory progress, 3. to
follow their assigned schedule of classes, 4. present themselves in strict Dress Code, 5. take the dance training offered at
DTHS seriously, always showing a respectful attitude toward instructors and administrative staff, 6. to believe in
themselves and remain committed and optimistic, 7. to perform during the Culminating Performance at the end of the
Summer Session.

All students must sign in and out each day at the Sign-In Desk during Summer Intensive Sessions.
Students should arrive at least one half hour early to stretch and warm-up before class.

All Students are required to keep a journal of their experience at DTHS, to include input from faculty regarding
corrections and exercises for each class, etc. Students must bring their journal daily and have it available upon request.
Journals will be checked periodically throughout the Summer Intensive programs.

The Student Affairs Officer will assign Lockers at the beginning of the session however, you must supply your own lock.
Anyone utilizing an unassigned locker will have his or her lock clipped immediately. Changing clothes is allowed in locker
rooms or bathrooms only – never in the Lobby, stairwells or hallways. DTHS is not responsible for lost or stolen items,
secure your belongings!

Students may use the Basement Lounge and the second floor Terrace for breaks and to consume food. Food
consumption is not allowed on the Lobby level, 2nd or 3rd floors. Do not consume food in the Locker Rooms. DTH
recycles! Kindly dispose of your cans, bottles and plastic items in the blue recycling bins and place all other trash in
regular trash receptacles. The refrigerator and microwave may be used but the stove is never to be used by students.

Students are NOT permitted in the Administrative Offices unless they are conducting business with Staff or Faculty.
Students are NOT permitted to use the elevator to go to classes, except in cases where physically necessary (e.g. Injury).

Gum chewing, smoking, drugs, alcohol and weapons are prohibited at Dance Theatre of Harlem. Any student caught with
drugs, alcohol or weapons will automatically be expelled. Smoking directly in front of the building’s entrance is strictly
prohibited. Any student found pilfering or defacing DTHS property will be permanently dismissed.

SOCIAL MEDIA: Students may not use social media sites to publish disparaging or harassing remarks about DTHS
community members, including, but not limited to, faculty, staff, and students.

Students who choose to post editorial content to websites or other forms of online media must ensure that their
submission does not reflect poorly upon The Dance Theatre of Harlem.

Dance Theatre of Harlem School takes bullying in all forms very seriously! Students who are accused of bullying
will be called to conference with their parents, the school administrator and the school artistic director. Bullying includes,
but is not limited to verbal and/or physical abuse, intimidation, and abuse via social media, phone, email, etc.

Cell Phones must be turned to vibrate/manner mode upon entering the building and must be left in the locker room or
with your belongings. A cell phone being used in the studio will be confiscated and a parent will be required to come to
DTHS to pick it up.
Students are not allowed to receive or make telephone calls at the Front Desk or in the
Administrative offices unless there is an emergency. Only in an emergency situation will School Administrative staff take
a message for a student. A public telephone is available on the basement level.

SUMMER SESSION EVALUATION: All Students are evaluated at the end of their Session. Evaluations are based on
the following criteria: Attendance, Attitude, Concentration, Improvement, and overall Performance. The Culminating
Performances are an essential part of the Summer Session programs and are mandatory for all students.

SICK DAYS: Students are required to call and speak with the Student Affairs Officer (ext. 421) or leave a voice mail if
they are unable to attend class. A doctor’s note is required from students who are sick more than three (3) consecutive
days.

ABSENCES & LATENESS: Summer Intensive Students are allowed two (2) absences. Two instances of being late
are equivalent to one absence. Any additional absences may be accepted at the discretion of the DTH School
Administrator if an acceptable explanation is provided in writing by the parent/guardian in advance. Excessive absences
or lateness will result in a warning, probation, and loss of award (e.g. scholarship /financial aid), suspension or expulsion
at the discretion of the School Director.

WITHDRAWAL: A Formal Letter of Withdrawal must be submitted to the Registrar to constitute an official
withdrawal from the School. (Note: the Refund Policy on the ADMISSION REQUIREMENTS FORM).
NOTES TO PARENTS/GUARDIANS: 1. All adults entering the building must sign in at the reception area. Due to limited
waiting area space, only one Parent/Guardian should accompany a student to the Dance Theatre of Harlem. 2.
Parents/Guardians must wait in the designated areas: the basement lounge and seating areas or the back lobby waiting area.
3. Parents are not allowed to use the elevators unless physically necessary. 4. Parents/Guardians are not allowed at studio
doorways or in the dance studios for observation, or to wait in the front Lobby while classes are in session. 5. Flash
photography or videotaping is prohibited during classes and or performances unless other arrangements have been made by
DTHS staff. 6. Contact the School Administrator or Student Affairs Officer for any Emergency at 212.690.2800.
FINANCIAL REGULATIONS:




Tuition is payable in full at the beginning of the session unless installment payment arrangements have been made. An
additional late fee of $40.00 for Summer Session Tuition is incurred after the due date.
Students who are delinquent in paying their tuition will not be allowed to take part in any classes until their balances are
brought up to date. Students with outstanding balances from a previous session will not be permitted to register.
Dance Theatre of Harlem School does not accept personal checks as a form of payment for application, tuition or
registration fees. We accept money orders, credit cards (Visa, MasterCard, Discover and American Express), travelers
checks and cash.
If tuition is paid in full and the student is unable to attend, or decides to withdraw from classes, refund of tuition will be
made in accordance to the schedule below:

Before the First Day of Class:
100% of total amount

Within First Week of Classes:
50% of total amount

After the First Week of Classes:
NO REFUND
No refunds are given to students who have been suspended or dismissed from the Dance Theatre of Harlem School.
I am a DTHS student & I agree to abide by the Rules & Regulations explained above.
____________________________________________________________
Signature of Student
____________________________________________________
Signature of Parent (students 18 years or younger)
(1/2016)
PARENT’S CODE OF CONDUCT
(To be submitted for students age 18 or younger)
It is the intention of this program to promote respect for all participants within all levels of the Dance Theatre
of Harlem School. It is expected that all parents/guardians of participants read and understand the Parent’s
Code of Conduct and continue to observe and follow all the principles contained within the Code.
1. I will remember that my child participates for his/her enjoyment. I will not force my child to participate in the arts. I
will try to make it FUN!
Initial: ______
2. I will insist that my child participates in a safe and healthy environment. I will support an arts environment that is
free of disrespectful behavior, inappropriate conversations, public critiques of student artists or the program, and I
will refrain from this behavior at all times. I will encourage my child to abide by the rules and to resolve conflict
without resorting to disrespect, hostility or violence in person, in verbal communication, through social media, etc. I
will and I will encourage my child to respect and show appreciation for the staff and volunteers who give their time to
the success of the program for my child.
Initial: ______
3. I will teach my child that doing one’s best is the primary goal so that my child will never feel defeated by the
outcome of casting or placement. I will never ridicule or yell at my child for his/her casting or placement. I will not
compare my child’s casting or placement to other dancers openly in public or in front of my child. I will make my child
feel successful every time by offering praise for working hard and following through on his/her commitment.
Initial: ______
4. I will remember that children learn by example. I will applaud talent by both my child and other student artists. I will
not be critical of, or embarrass any student artist, at any time.
Initial: ______
5. I will leave the artistic vision, programming and casting to the artistic staff. I will never question the artistic team’s
judgment, intention or honesty in public. I will trust that decisions have been made with integrity and strategy for the
overall good of the program and the participants. I will encourage my child to participate in a manner consistent with
the program’s philosophy.
Initial: ______
6. I will emphasize skill development and a serious approach to training (classes, rehearsals, and production weeks)
and explain how skill development and consistency in training will benefit my child. I understand the benefits from
participating in a rigorous arts training program, the commitment, the discipline and the social skills learned and
acquired. I will attempt to learn about the arts world so that I may best support my child’s development in the field.
Initial: ______
7. I will communicate and report any concerns regarding inappropriate behavior to a member of the Artistic/Program
Staff (School Director, Student Affairs Officer, School Administrator or Faculty). I will communicate all questions about
the programming through the proper channels as well, respectfully understanding the role of each member of the staff.
I will communicate in a professional manner at an agreed upon time and place, respecting the personal time of the
staff.
Initial: ______
I have read and understand the above Code of Conduct, and agree to abide by it at all times. I understand that if
I do not follow this Code of Conduct, I may be asked to cease an activity (such as observing in the hallways or
volunteering backstage) or I may be asked to withdraw my child from the program.
________________________________________________________________________________
Parent/Guardian Signature
______________
Date
DANCE THEATRE OF HARLEM SCHOOL
TRAVEL PERMISSION FORM
Please circle the response that applies to your child and be sure to sign and return this document to the
school staff. This form is for students 18 years or younger only.
I, _____________________________________do /do not (circle one) hereby give my
son/daughter __________________________________ permission to leave the Dance
Theatre of Harlem School without adult supervision, and to travel alone to a predetermined
destination.
The list of persons below, are individuals who are permitted to escort my child from the Dance
Theatre of Harlem premises in my absence.
1. ______________________________________________
2. ______________________________________________
3. ______________________________________________
4. ______________________________________________
Once my child leaves the DTHS building, I release DTH and its employees of all responsibility for the
safety and welfare of my child. I agree to notify the school staff by phone or email, if there are any
changes to this initial list.
_______________________________
Parent’s Signature
_____________________________________
Child’s Name
Age
________________
Date
___________________
Class/Program
DANCE THEATRE OF HARLEM SCHOOL
WAIVERS AND RELEASE AGREEMENTS
I am not aware of any medical condition my child has which would preclude him or her from participating in dance
activities. I understand there is a definitive risk of injury associated with dancing and that such injuries include, but are not
limited to bruises, dislocations, broken bones, torn or damaged muscles and ligaments, paralysis and even death. I
understand that such injuries may be caused in whole or in part by the student (my child), or by the actions or inactions of
other students or instructors.
1.
In consideration of being accepted for dance instruction by the Dance Theatre of Harlem School (DTHS), and in further
consideration of the expertise and achievements of instructors at DTHS and the limited number of students that may be
accepted by DTHS, my child and I agree to all of the following, which shall bind me and my child, and also my heirs,
assigned executors and administrators:
a.
b.
c.
I agree to instruct my child to immediately stop performing any activity if he or she feels any pain, dizziness,
light-headedness, or any other symptoms, and to immediately report those symptoms to the instructor. I also
agree to instruct my child to carefully follow the instructors’ directions, to ask for additional directions if he or
she does not understand any particular activity, and to immediately stop any activity which he or she is not
competent or confident enough to perform.
Initial: ______
To the fullest extent permitted by law, I agree and represent that I and my child assume the risk and
responsibility for any and all injuries to my child that he or she sustains while performing any dance activities,
including any and all costs and damages that are a consequence of such injuries, and whether such injuries,
costs and damages were caused in whole or in part by DTHS, instructors, students or employees.
Initial: ______
To the fullest extent permitted by law, I and my child agree to defend, indemnify and hold harmless DTHS and
their instructors, agents, employee, contractors, clients and students, from and against all claims, costs,
damages, losses and expenses, including but not limited to attorney’s fees, arising out of or resulting from my
child’s performance or other participation in any dance or aerial activities, regardless of whether or not such
claim, cost, damage, loss or expense was caused in part by a party indemnified hereunder.
Initial: ______
I have fully read and agree to all of the above, my child and I make this agreement and the representations herein in order to
induce Dance Theatre of Harlem School to accept my child as a student for dance instruction.
Limited Use Photographic Release
For and in consideration of my engagement as a student by the Dance Theatre of Harlem School (hereafter referred to as
DTHS) on terms hereinafter stated, I hereby give the Photographer/Videographer and DTHS, their legal representatives and
assigns, those for whom the Photographer/Videographer and DTHS are acting, and those acting with their permission, the
right to copyright and/or use, reuse and/or publish, and republish the photographic pictures/film of me taken during the
course of my study at DTHS or at any School performances. I hereby waive any right to inspect or approve the finished
photograph(s)/video(s) prior to publication. I hereby release, discharge and agree to save harmless the Photographer
/Videographer and DTHS, their representatives, assigns, or any other person or persons, corporation or corporations, for
whom they might be acting, including any firm publishing and/or distributing the finished product, in whole or in part, from
and against any liability as a result of it’s publication or distribution of the same. I certify that I am suffering under no legal
disabilities and that I have read the foregoing release, authorization and agreement, before affixing my signature below, and
warrant that I fully understand the contents thereof.
_________________________________________________________
SIGNATURE PARENT/GUARDIAN
_________________
DATE
__________________________________________________________
SIGNATURE STUDENT
__________________
DATE
DANCE THEATRE OF HARLEM SCHOOL
PARENTAL TRIP CONSENT FORM
All students who participate in Dance Theatre of Harlem’s 2016 Summer Intensive Programs will enjoy a minimum
of one field trip during their Summer Intensive session. Below you will find a general permission slip that will give
your child permission to participate in a scheduled activity.

Transportation to and from the event will be provided by subway, if necessary.

Students will travel with adult chaperones at a ratio no greater than 8 students to 1 adult.

A parent or student (18 years of age or older), must sign and return the bottom portion of this consent form
acknowledging permission to attend the Summer Intensive 2016 scheduled activity.
I, __________________________________________________________  do authorize my child  do not authorize my child
Name of Parent or Student 18 yrs+ (print)
________________________________________________________________________________________________________________________
Student’s Name
Age
Summer Session I or II
to attend the Dance Theatre of Harlem field trip. I also agree to indemnify Dance Theatre of Harlem, Inc. and its
employees, and anyone else associated with DTH against any injury, theft or loss of property not resulting from
negligence by any one of the parties mentioned above.
________________________________________
Parent/Guardian (SIGNATURE)
_____________________________________/____________________________
Mobile Phone
Home Phone
466 WEST 152ND STREET, NEW YORK, NY 10031-1814 T: 212.690.2800 F: 212.690.8736
WEBSITE: DANCETHEATREOFHARLEM.ORG
Dance Theatre of Harlem School
STUDENT DRESS CODE
SUMMER INTENSIVE SESSION 2016
Dance Theatre of Harlem School (DTHS) requires that all students adhere to a strict dress code. Attention to
presentation says that a dancer cares about who they are and how they look, and is a part of a student’s professional
training.
DRESS CODE GUIDELINES:
DTHS requires students to purchase and to report to class in proper DTHS uniform – no leg warmers, sweats, head
coverings, multicolor leotards, etc. are allowed. JEWELRY is not to be worn in class; students are encouraged to leave all
jewelry at home. ONLY STUD EARRINGS ARE ALLOWED IN CLASS.
All students should have their name on the inside of dance clothing and shoes to prevent loss! Items may be
purchased at the DTHS Dance Boutique before classes begin or at the institution of your choice.
DTHS Summer Uniform - FEMALES:

Leotards: The female uniform consists of a black leotard with camisole or tank straps. Each student
must purchase 1 black leotard from the DTHS Boutique to be used as their costume for
the culminating performance.

Tights: Must be flesh tone, as close to the student’s natural skin color as possible. Students taking
various dance disciplines may require bare feet, so it is necessary to purchase “transitional tights” which
are available at all dancewear stores. Students are expected to wear tights without runs or holes.

Ballet slippers: Must be flesh tone. Dancers should arrive to class with their shoes sprayed to match
their tights. DTHS requires female students to spray their ballet slippers and pointe shoes, to prevent a
break in the “line”. That is, when you see one shade of skin tone at the top of the body, you should see
the same below. Nu Life Color Spray by Kiwi and Melatonin are brands often used at DTHS and are
readily available at the DTHS Dance Boutique. Slippers are to be sprayed off campus. The SPRAYING
OF SHOES WITHIN DTHS OR IN FRONT OF THE BUILDING IS PROHIBITED.

Hair: Female students must wear their hair swept back and up in a secured ballet bun (braids or very
short styles are acceptable but must be neat, no bangs or head coverings).
DTHS Summer Uniform - MALES:




T-shirt: a fitted white short sleeved or tank dance top. Undershirts (Fruit of the Loom, Hanes, etc.) are
not recommended.
Tights or Leggings must be black (no runs or holes), coupled with a dance belt and white socks.
Slippers: white ballet slippers kept clean and un-scuffed.
Hair: must be neat, no head coverings.
FOR ALL:



Tap
Modern & African Classes:
Jazz:
Black Tap Shoes ( No Heel)
Bare feet
Black Jazz shoes
Suggested dancewear stores: 1. Capezio – 201 Amsterdam Avenue & 69 St.-212.586.5140 / 1650 Broadway & 51 St.
(2nd Fl.) – 212.245.2130; 2. Sansha – 888 Eighth Ave. & 53 St. - 212.246.6212; 3. Danskin – 159 Columbus Avenue 212.724.2992
DANCE THEATRE OF HARLEM SCHOOL
PAYMENT INSTRUCTIONS
SUMMER SESSION 2016
Step 1: Registration and Activity Fee
The non-refundable Registration/Activity Fee ($200), is separate from the tuition fee and
must be paid in order to reserve space in the program. This payment is due on the date
indicated on the acceptance letter, along with a signed copy of the acceptance letter and
completed registration documents. Registration/Activity fees must be paid via email or
regular mail only. Credit cards, bank checks and money orders are accepted. No personal
checks please.
Step 2: Tuition Payment
Once Step 1 of the registration process is complete, families will be given access to DTH’s Online
Student Account Management System (OSAMS), via email. Via the OSAMS system, families can make
tuition payments using Visa, Amex, Mastercard, or Discover. Families may also make payments by
email, mail or in person using the enclosed Summer Payment Form. Families may pay tuition in full,
or follow the installment schedule below. Payment forms are also available on our website at
dancetheatreofharlem.org.
Installment Payment Schedule
*Tuition Fee
SESSION 1
$
950.00
25-Mar-16
$
*Tuition Fee
SESSION 2
$
1,200.00
316.67
22-Apr-16
$
25-Mar-16
$
400.00
316.67
20-May-16
$
22-Apr-16
$
400.00
316.67
20-May-16
$
400.00
If tuition is paid in full and the student is unable to attend, or decides to withdraw from classes,
the refund of tuition will be made in accordance to the schedule below:

Before the First Day of Class:

Within First Week of Classes:

After the First Week of Classes:
100% of total amount
50% of total amount
NO REFUND
466 West 152nd Street, New York, NY 10031-Tel. (212) 690-2800-Fax. (212) 690-8736-dancetheatreofharlem.org
DANCE THEATRE OF HARLEM SCHOOL
SUMMER PAYMENT FORM
Type of Payment:
Program:
 Registration /Activity Fee
 Session I
 Tuition Fee
 Session II
Level: ________________________Phone:#_______________________________________
Email Address: ______________________________________________________________
Student’s Name: ____________________________________________________________
Last
First
Middle Initial
Type of Payment:  Cash  Certified Bank Check  Money Order
 Travelers Check (Please make payment to “Dance Theatre of Harlem”)
NO PERSONAL CHECKS ACCEPTED
Payment Amount: $_______________________________
Please charge:
 Visa
 Master Card
 American Express
 Discover
_________________________________________________________________________________________________
Cardholder Name
(Please print clearly)
__________________________________________________________________________________________________
Cardholder Signature
Amount Charged: $_________________________________ Zip Code ______________________________
_______________________________________________________ ____________________
Card Number
Exp. Date
________________
Sec. Code
(3-or 4-digit)