Registration
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Welcome to Winter Camp (9-11yrs) registration! Please, provide your information below and click Submit when complete. Charges will be posted to you after your registration has been reviewed and a place has been approved. If you have questions before registering, please send an email to dance@russianschoolofballet.com.
Event:
Start Date/Time:
End Date/Time:
Fee per Student:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Type
*
Doctor/Physician
Father
Grandparent
Guardian
Mother
Other
Parent
Step Father
Step Mother
Home Phone:
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State/Prov:
*
Postal Code:
*
Emergency Contact Info
*
Students entered below will be added to your family's account
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=dd/mm/yyyy)
Student Personal Email (age 13&over):
School:
*
Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilites (if non, leave empty):
Allergies (if non, leave empty):
Medications (if non, leave empty):
Primary Doctor:
Previous dance school/training:
*
Current dance school/training:
*
Other interests/activities:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=dd/mm/yyyy)
Student Personal Email (age 13&over):
School:
*
Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilites (if non, leave empty):
Allergies (if non, leave empty):
Medications (if non, leave empty):
Primary Doctor:
Previous dance school/training:
*
Current dance school/training:
*
Other interests/activities:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=dd/mm/yyyy)
Student Personal Email (age 13&over):
School:
*
Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilites (if non, leave empty):
Allergies (if non, leave empty):
Medications (if non, leave empty):
Primary Doctor:
Previous dance school/training:
*
Current dance school/training:
*
Other interests/activities:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=dd/mm/yyyy)
Student Personal Email (age 13&over):
School:
*
Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilites (if non, leave empty):
Allergies (if non, leave empty):
Medications (if non, leave empty):
Primary Doctor:
Previous dance school/training:
*
Current dance school/training:
*
Other interests/activities:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
Female
Male
Birth Date:
*
(format=dd/mm/yyyy)
Student Personal Email (age 13&over):
School:
*
Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Disabilites (if non, leave empty):
Allergies (if non, leave empty):
Medications (if non, leave empty):
Primary Doctor:
Previous dance school/training:
*
Current dance school/training:
*
Other interests/activities:
*
Questions/Options:
Current Ballet School
*
Level
*
How long have you been training?
*
How many hours a week do you train currently?
*
Have you had the following training?
Pointes
Yes
No
If yes, please state the number of years/months
Modern
Yes
No
If yes, please state the number of years/months
Historical Dance
Yes
No
If yes, please state the number of years/months
Contemporary
Yes
No
If yes, please state the number of years/months
Other
Would you like to qualify for for the Early Bird Special and pay in full before 1st June the reduced fee of R3400?
Yes
No
Additional Information:
CONSENT FORM
I, hereby indemnify, do not hold responsible and absolve The Russian School of Ballet and the teachers conducting Winter Camp from any claim whatsoever that may arise in connection with any loss or damage to the property of, or injury to myself or the person/child/ward stated above that might be sustained during the above Winter Camp or whilst travelling to or from same at any of the venues where the Winter Camp is being held.
I acknowledge that I have read the foregoing, understand the terms contained herein, and this Consent Form has been executed voluntarily. I have read the above. I understand that by participating in the Russian School of Ballet Winter Camp I'm assuming the risks associated with doing so.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
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