Jones School of Ballet Online Registration

Registration

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Welcome to Jones School of Ballet! We are thrilled you are here. We have made enrolling easy and convenient! Please complete the following registration form to enroll. We look forward to having you!

* denotes required fields

Referral Information

How did you hear about us?

Referral Name

Family Information

Family Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info (Name, Relation, Phone Number)*

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

Portal Account Password

Confirm Portal Account Password

Contact #2

Contact #2 First Name

Last Name

Type

How can we contact you?

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Type NONE if no allergies)*

Primary Doctor*

Please click on the "Select Class" button below to get started.

Level 3 through Level 5 are required to attend two ballet classes/week.

For example: Student: Megan Jones Grade Level: 5th Click on "Select Class" and then select Level 3 Ballet and Level 3 Technique for your two ballet classes/week.

All classes are subject to change/cancellation pending on number of registrants.

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Type NONE if no allergies)*

Primary Doctor*

Please click on the "Select Class" button below to get started.

Level 3 through Level 5 are required to attend two ballet classes/week.

For example: Student: Megan Jones Grade Level: 5th Click on "Select Class" and then select Level 3 Ballet and Level 3 Technique for your two ballet classes/week.

All classes are subject to change/cancellation pending on number of registrants.

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Type NONE if no allergies)*

Primary Doctor*

Please click on the "Select Class" button below to get started.

Level 3 through Level 5 are required to attend two ballet classes/week.

For example: Student: Megan Jones Grade Level: 5th Click on "Select Class" and then select Level 3 Ballet and Level 3 Technique for your two ballet classes/week.

All classes are subject to change/cancellation pending on number of registrants.

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Type NONE if no allergies)*

Primary Doctor*

Please click on the "Select Class" button below to get started.

Level 3 through Level 5 are required to attend two ballet classes/week.

For example: Student: Megan Jones Grade Level: 5th Click on "Select Class" and then select Level 3 Ballet and Level 3 Technique for your two ballet classes/week.

All classes are subject to change/cancellation pending on number of registrants.

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

Grade Level*

Disabilities (Leave blank if NONE)

Special Needs (Leave blank if NONE)

Allergies (Type NONE if no allergies)*

Primary Doctor*

Please click on the "Select Class" button below to get started.

Level 3 through Level 5 are required to attend two ballet classes/week.

For example: Student: Megan Jones Grade Level: 5th Click on "Select Class" and then select Level 3 Ballet and Level 3 Technique for your two ballet classes/week.

All classes are subject to change/cancellation pending on number of registrants.

Enroll in Classes

Select Class *

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Please fill out CREDIT CARD Payment Method

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

City

State

Zip*

eCheck/Bank Draft

Bank Name

Account Type

Your Account Name (Your name on your bank statement)

Bank Routing Number (9-digit number)

Account Number

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Registration

Referral Information

Family Information

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Contact #2

How can we contact you?

Student #1

Additional Info

Enroll in Classes

Student #2 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #3 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #4 (Show-Hide Details)

Additional Info

Enroll in Classes

Student #5 (Show-Hide Details)

Additional Info

Enroll in Classes

Required Policies (Show-Hide Details)

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Questions or Concerns

Payment Information

Credit Card

eCheck/Bank Draft

Required Policies

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