Registration

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The Holidays are coming and we know that parents need some extra time to get things done. Enjoy a parent's night out and bring your child to a fun and exciting event! Children ages 5-11 can make crafts, eat snacks, play games, hear stories, and of course DANCE! This Nutcracker themed event is a pajama party, wear your cutest and comfiest!

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Relationship *
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

Students entered below will be added to your family's account

Add New Student #1:

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	Student's First Name: *	Last Name: *
	Birth Date: *	(format=mm/dd/yyyy)
	School:*	Grade Level:*
	Allergies (Leave blank if NONE):
	Medications (Leave blank if NONE):
	Disabilities :
	Special Needs :
	Student Pronouns:
	Student Email:

Questions/Options:


Child's name *
Parent's name *
Parent's phone number *
Parent's email *
Child's age *
does your child attend Dayton Ballet School?*
Does your child have any food allergies?*

Additional Information:

Payment

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Assumption of risk

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Medical Emergency

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Media Release

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Enter your Full Name: