San Diego Civic Youth Ballet Online Registration

Registration

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REGISTRATION Forms are ONLINE with SDCYB Thank you for your interest in the San Diego Civic Youth Ballet! ENROLLMENT in classes is not done online and is NOT FINAL until payment is received. Enrollment is on a first come, first served basis. Please contact us at 619-233-3060 or visit us in the office to enroll your student and pay for classes. SDCYB's enrollment hours are Monday-Friday 12:00pm-6:00pm & Saturday's 9:00am-1:00pm.

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Referral Information

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Referral Name

Family Information/Student Demographics

Last Name*

Where do you live?

Home Address*

City*

State*

Zip*

Primary Phone*

Additional Info

Emergency Contact Info*

Asian/Asian American (Y)*

Black/African American (Y)*

Hispanic/Latino/Latina (Y)*

White (Y)*

OTHER: Please Specify*

Contact #1

Contact #1 First Name*

Last Name *

Type*

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Home Phone *

Work #

Cell # *

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Email* (Emails are kept confidential)

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Portal Account Password

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Who is your employer?

Employer

Employer Phone

Employer Notes

Contact #2

Contact #2 First Name*

Last Name*

Type*

How can we contact you?

Home Phone

Work #

Cell # Receive Text Message Notifications. By opting in, you agree to receive SMS messages from San Diego Civic Youth Ballet. Standard message and data rates apply. Reply STOP to opt out

Email (Emails are kept confidential)

Confirm Email

Who is your employer?

Employer

Employer Phone

Employer Notes

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Special Accomodations

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SDCYB Level (If Known)

Photo/Video Release (Y/N)*

Use child's name in Media(Y/N)*

Benadryl: (Y/N)*

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Special Accomodations

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SDCYB Level (If Known)

Photo/Video Release (Y/N)*

Use child's name in Media(Y/N)*

Benadryl: (Y/N)*

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Special Accomodations

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SDCYB Level (If Known)

Photo/Video Release (Y/N)*

Use child's name in Media(Y/N)*

Benadryl: (Y/N)*

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Special Accomodations

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SDCYB Level (If Known)

Photo/Video Release (Y/N)*

Use child's name in Media(Y/N)*

Benadryl: (Y/N)*

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date*

Additional Info

T-Shirt Size

School*

Grade Level*

Special Accomodations

Allergies (Leave blank if NONE)

Medications (Leave blank if NONE)

SDCYB Level (If Known)

Photo/Video Release (Y/N)*

Use child's name in Media(Y/N)*

Benadryl: (Y/N)*

Add Another Student

Required Policies

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Questions or Concerns

Comments

Payment Information

Account Information

Demographic of Student*

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Registration

Referral Information

Family Information/Student Demographics

Where do you live?

Additional Info

Contact #1

How Can We Contact You?

Portal Access (your email is your login)

Who is your employer?

Contact #2

How can we contact you?

Who is your employer?

Student #1

Additional Info

Student #2 (Show-Hide Details)

Additional Info

Student #3 (Show-Hide Details)

Additional Info

Student #4 (Show-Hide Details)

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Student #5 (Show-Hide Details)

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