Registration
Congratulations! By completing this form, you are officially confirming your student's enrollment in the 2021 5-Week Summer Ballet Program - BEGINNING LEVEL A.

SELECT ONE CLASS ONLY: 9:00 AM or 5:30 PM. If you are interested in your dancer attending both, please indicate this to be added to the interest list. If space allows, we will be in touch.
Event:
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Type*
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
 
Address: *
City: * State: * Zip: *
Emergency Contact (Include name, address, phone number, e-mail)*
 
 
Students entered below will be added to your family's account
 
Questions/Options:
Does the student have at least one year of ballet or dance training?*
If yes, please tell us briefly about their ballet/dance training (school, number of classes per week, etc.)
Student's age at start of program (June 21, 2021).*
CLASS SELECTION: Click here for the 9:00 - 10:00 AM Monday - Friday class. (checked=yes)
CLASS SELECTION: Click here for the 5:30 - 6:30 PM Monday - Friday class. (checked=yes)
Click here to be added to the interest list for both the 9:00 AM and 5:30 PM classes. If space allows for your dancers to attend both, we will contact you. (checked=yes)
 
Additional Information:
 
CONFIRMING ENROLLMENT IN PROGRAM
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I've read the above and agree.
 
ALL FEES DUE UPON SUBMISSION
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PAYMENT AND REFUND POLICIES
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PUBLICITY RELEASE
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FINANCIALLY RESPONSIBLE PARTY
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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: *
Nickname:
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*