All students must audition to be accepted into the program. Audition/Placement will be determined by an individual audition and/or performance in class. Both current and new applicants are evaluated and placement is determined for the following academic year during the summer. All applications are considered in the order received.
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
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
Current dance school?*
What goals would you like to achieve by attending this program?*
Do you have any career goals as a dancer?
Are you interested in the 3 day (Pre-Pro I) or 5 day (Pre-Pro II) program?
How many years of experience doing Ballet?
How many years have you danced on pointe?
How many years of dance experience with Contemporary?
Any other special information we should know about you?
Additional Information:
Release of Liability
As the enrolled participant and/or the parent/guardian of the participant, I agree and understand that dance/fitness/ training is a potentially hazardous activity. I recognize that there are risks inherent in dance training including but not limited to serious physical injury. The participant hereby agrees to participate in activities of the Campaneria Ballet School (CBS) and hereby agrees to indemnify and hold harmless CBS, its instructors, officers, directors, agents and employees against any liability resulting from any injury that may occur to the participant while participating in activities of the CBS. The participant also agrees to indemnify CBS for any damages incurred arising from any claims, demand, action or course of action by the participant. The participant authorizes any representative of CBS to have the participant treated in any medical emergency during their participation in activities of the CBS. Further, the participant and/or parent/guardian agree to pay all costs associated with medical care and transportation for the participant.
• Any medical/health problems, of which the staff must be aware, are disclosed in the Important Health Information section of the Registration Form.

I've read the above and agree.
Enter your Full Name: *   
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*