Registration
1 openings left in this event!
Already a customer? Click here to login.
Orlando Ballet has a dance program dedicated to youth with special needs. This adaptive dance program is called ‘Come Dance With Us!’ ‘Come Dance With Us!’ has brought together Orlando Ballet’s professional dancers, medical experts and some of the brightest children in Central Florida to give them the opportunity to experience classical ballet in a special way. Central Florida’s Healthcare professionals from both Nemours Children’s Health Systems Florida and Orlando Health Arnold Palmer Hospital for Children are an integral part of this program. They provide insightful ways to design the CDWU workshops around the needs of the participants. There are two sections of Come Dance With Us!: One on Sundays for children 3-10, one on Wednesdays for youth 11-16. Classes are held at Harriett's Orlando Ballet Center, located at 600 N Lake Formosa Drive, Orlando, FL, 32803 from 9:00 AM-10:00 AM. While the workshops are free, the remaining classes cost $125.
Event:
Start Date/Time:
End Date/Time:
Fee per Family:
Room:
*
- denotes required fields
Family Information
First Name:
*
Last Name:
*
Relationship
*
Caregiver
Father
Guardian
Mother
Parent
Self
Home Phone:
*
Cell #:
Work #:
Email:
*
(Emails are kept confidential)
Address:
*
City:
*
State:
*
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NE
NC
ND
NH
NJ
NM
NY
NV
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Zip:
*
Emergency Contact Info (Not Contact #1 or #2)
*
Add New Student #1:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student's School:
Student's grade:
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
Medical Conditions (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Dancer's Race/Ethnicity:
*
Other languages spoken?:
New or returning student?:
*
Add New Student #2:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student's School:
Student's grade:
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
Medical Conditions (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Dancer's Race/Ethnicity:
*
Other languages spoken?:
New or returning student?:
*
Add New Student #3:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student's School:
Student's grade:
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
Medical Conditions (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Dancer's Race/Ethnicity:
*
Other languages spoken?:
New or returning student?:
*
Add New Student #4:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student's School:
Student's grade:
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
Medical Conditions (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Dancer's Race/Ethnicity:
*
Other languages spoken?:
New or returning student?:
*
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Student's School:
Student's grade:
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
Medical Conditions (Leave blank if NONE):
Allergies (Leave blank if NONE):
Medications (Leave blank if NONE):
Dancer's Race/Ethnicity:
*
Other languages spoken?:
New or returning student?:
*
Questions/Options:
How did you hear about us?
*
Does your dancer require any equipment in the studio with them for class?
*
Please provide any details or medical information about your dancer that will help us assist them.
*
Additional Information:
Liability & Consent to Medical Treatment
(Show-Hide Details)
I am aware that dance and the nature of the training and performing associated with Orlando Ballet School place unusual stress on the body and carry with them the risk of physical injury. On behalf of my child and myself, I assume the risk and agree that Orlando Ballet, Orlando Ballet School, and the staff of this institution shall not be liable in any way for injuries sustained during attendance in classes, rehearsals, or any related functions.
It is also understood that dance instruction involves kinetic corrections that may include physically touching a student as part of regular class work and rehearsals. Parents or students with any concerns should speak with their instructors before class.
I've read the above and agree.
Photo Release
(Show-Hide Details)
I hereby grant to Orlando Ballet, and their respective licensees, successors and assigns, the right and permission, with respect to photographs and videos taken of me or the minor named below on whose behalf I am signing, and with respect to any printed matter in connection therewith, to do the following:
1. To include such photographs and video in all media, and in advertising, publicity and promotion thereof.
2. To use my name or the name of the minor on whose behalf I am signing, in connection with
the foregoing.
I hereby release, discharge and agree to indemnify and hold harmless Orlando Ballet and their respective heirs, legal representatives, licensees, successor and assigns, from all claims and demands whatsoever arising out of or in connection with the foregoing, and waive any right to inspect or approve the same.
I hereby certify that I am the Parent and/or guardian of a minor under the age of eighteen years and hereby consent on behalf of said minor to the use of any of the photographs and video taken of said minor pursuant to the terms set forth in this photo/video release, including, without limitation, the release, discharge and hold harmless provisions thereof.
I've read the above and agree.
Lobby Policy
(Show-Hide Details)
I am aware that the lobby may not be available as a waiting area while my child is participating in this program and that OBS staff reserves the right to change this policy as necessary. I am aware that the lobby is intended to be a quiet location so that participants in the studios can focus on instruction.
I've read the above and agree.
Enter your Full Name:
*
Other Questions/Comments:
Please Wait...
