American Midwest Ballet Online Registration

Registration

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Welcome to American Midwest Ballet (AMB) School! To register for classes, fill out the form below and click ‘submit’. Credit cards will be charged for the registration fee at this time. All enrollments are considered pending until we have reviewed your registration and posted any fees due. Applicable discounts will also be applied at that time.

* 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*

Home or Primary Phone*

Additional Info

Emergency Contact Info (Not Contact #1 or #2)

Contact #1

Contact #1 First Name*

Last Name *

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

Student #1

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Grade Level

Allergies (Leave blank if NONE)

ACADEMY DIVISION STUDENTS: Will need to contact the office or email school@amballet.org to enroll in classes. Academy classes are not available to register online.

COMMUNITY DIVISION STUDENTS: "Select Class" below to view, select and register for available classes.

PAYMENT: Monthly tuition is paid trough autopay via credit card on file.

Enroll in Classes

Select Class

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Grade Level

Allergies (Leave blank if NONE)

ACADEMY DIVISION STUDENTS: Will need to contact the office or email school@amballet.org to enroll in classes. Academy classes are not available to register online.

COMMUNITY DIVISION STUDENTS: "Select Class" below to view, select and register for available classes.

PAYMENT: Monthly tuition is paid trough autopay via credit card on file.

Enroll in Classes

Select Class

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Grade Level

Allergies (Leave blank if NONE)

ACADEMY DIVISION STUDENTS: Will need to contact the office or email school@amballet.org to enroll in classes. Academy classes are not available to register online.

COMMUNITY DIVISION STUDENTS: "Select Class" below to view, select and register for available classes.

PAYMENT: Monthly tuition is paid trough autopay via credit card on file.

Enroll in Classes

Select Class

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Grade Level

Allergies (Leave blank if NONE)

ACADEMY DIVISION STUDENTS: Will need to contact the office or email school@amballet.org to enroll in classes. Academy classes are not available to register online.

COMMUNITY DIVISION STUDENTS: "Select Class" below to view, select and register for available classes.

PAYMENT: Monthly tuition is paid trough autopay via credit card on file.

Enroll in Classes

Select Class

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Student Gender*

Birth Date* (format=mm/dd/yyyy)

Additional Info

Grade Level

Allergies (Leave blank if NONE)

ACADEMY DIVISION STUDENTS: Will need to contact the office or email school@amballet.org to enroll in classes. Academy classes are not available to register online.

COMMUNITY DIVISION STUDENTS: "Select Class" below to view, select and register for available classes.

PAYMENT: Monthly tuition is paid trough autopay via credit card on file.

Enroll in Classes

Select Class

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

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*

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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)

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)

I Agree to All of the Above

Questions or Concerns

Payment Information

Credit Card

Required Policies

(Show-Hide Details)