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A back-to-school workshop for your budding ballet star! Dancers will work on enhancing their technique through barre work, center exercises, traveling steps, stretching, strengthening, and a classical ballet variation. The Juniors Workshop is for the 10-13 year-old with at least 1 year of ballet experience.

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: *

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: *
	Student Gender:	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	Grade Level:
	Disabilities (Leave blank if NONE):
	Allergies (Leave blank if NONE):

Questions/Options:


Does your child have any allergies or medical conditions that we should be aware of? (For example, are they allergic to dyes, latex, or foods?)*

Additional Information:

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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:*

eCheck/Bank Draft:

Bank Name:

Bank Routing Number:

(9-digit number)

Your Account Name:

(Your name on your bank statement)

Your Account Type:

Account Number: