Register for Wait List

The 2017-18 class series is full.
Wow! The cotillion class filled in one day.  We are so thrilled that families are excited about this program and we look forward to meeting all of the new students in October.  

A wait list has been established and you are invited to add your child’s name to the list.  Students may be added from the wait list if space opens in the class.  New students may be added only prior to the first and second classes in the series in order to facilitate all students learning at a similar pace. The program is open to 7th and 8th grade students so if your 7th grader missed the chance to join this year, please consider joining next year.

Select Class*

Student Name*

Student Gender*


City/Zip Code*

Parent's Email*

Home Phone*

Dietary or Health Restrictions

How did you hear about us?


Date of birth

Grade in 2017-18 School Year


Parent/guardian name(s)

Parent guardian cell phone number

Additional emergency contact name/number

I am the class participant, or the parent/guardian of the class participant named above, and do hereby waive, release, and discharge all claims for damages, personal injury, and property damage which I may have or which may hereafter accrue to me as a result of participation in the class selected. I understand that accidents can occur during class. Knowing the risks of the class, I hereby agree to assume those risks. This release is intended to discharge and hold harmless Jill Pfeiffer Etiquette School LLC, its officers, and employees from liability. I further understand that photographs and videos may be taken of the class participant during the course of the said activity, and that these photographs and video may be used for Jill Pfeiffer Etiquette School promotional purposes. No child will be identified by name in pictures and videos used by Jill Pfeiffer Etiquette School.
By checking this box, I acknowledge that I have read, understood, and agree to the Waiver of Liability*
Parent/Guardian Full Name:

Parent(s) are invited to chaperone. No obligation required! (Some students prefer that their parents do not chaperone). While you will be asked to help out 10 min before the event, and at the refreshment time during the event, there is plenty of time to sit and watch the dancing and (discreetly) take photos. Please check the date(s) that you are available and we will do our best to accommodate one of your requested dates. Once the chaperone schedule is completed, a confirmation email will be sent parents.
October 20December 8January 19February 9March 16


Course Cancellation:
When registration does not meet the minimum enrollment required, it may be necessary to cancel a class. At the time of cancellation, Jill Pfeiffer Etiquette School will initiate a full refund. Class refunds may take two weeks to process.

Wait Lists:
A wait list will be established once a class has reached maximum enrollment. Students may be added from the wait list as space opens in the class. New students may be added only prior to the first or second classes in the series in order to facilitate all students learning at a similar pace.

Tuition secures a space in the class and refunds or credits are not issued if a student misses a dance class. Tuition is non-refundable after October 6, 2017. If a student must withdraw from cotillion class before the series begins, the tuition is refundable provided that a request for refund is received in writing no less than two (2) weeks prior to the first class. Withdrawal requests must be received (via US Mail or Email) by Jill Pfeiffer Etiquette School by October 6, 2017.

Courtesies of social dance will be stressed as an important part of instruction. If a student's behavior is disruptive or disrespectful (as determined by instructors) the student's parent(s) will be called and asked to pick up their child immediately.

By checking this box, I acknowledge that I have read, understood, and agree with the policies of Jill Pfeiffer Etiquette School LLC.*

Authorized By*: