Ballet Pensacola Online Registration

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Welcome to Ballet Pensacola’s 2019-20 season! Ballet Pensacola is committed to excellence in dance education. Not only do students learn the technical aspects of a fine art form, but they also develop self-confidence, self-motivation and self-assessment skills that will serve them well in all aspects of life. Have a great year!

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Referral Information

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Family Information

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Where do you live?

Home Address*

City*

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Zip*

Home or Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

Type

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Home Phone

Work #

Cell # *

Portal Access (your email is your login)

Email* (Emails are kept confidential)

Confirm Email*

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 # *

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* (format=mm/dd/yyyy)

Additional Info

Grade Level

Disabilites

Special Needs

Allergies

Medications

Previous Training Experience*

School Name*

Classes Taken*

Please click on the Search button below, then choose the class/es.

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

Disabilites

Special Needs

Allergies

Medications

Previous Training Experience*

School Name*

Classes Taken*

Please click on the Search button below, then choose the class/es.

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

Disabilites

Special Needs

Allergies

Medications

Previous Training Experience*

School Name*

Classes Taken*

Please click on the Search button below, then choose the class/es.

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

Disabilites

Special Needs

Allergies

Medications

Previous Training Experience*

School Name*

Classes Taken*

Please click on the Search button below, then choose the class/es.

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

Disabilites

Special Needs

Allergies

Medications

Previous Training Experience*

School Name*

Classes Taken*

Please click on the Search button below, then choose the class/es.

Enroll in Classes

Select Class

Add Another Student

Required Policies and Agreements

Harassment Policy Agreement

Ballet Pensacola's Academy is dedicated to the treatment of all persons with respect and dignity and to providing an environment that is free from any form of discrimination or harassment. The Academy prohibits and will not tolerate harassment of any kind to or by any persons, including teachers, staff, students, parents and any other person affiliated with or doing business with Ballet Pensacola's Academy. This prohibition includes harassment for any unlawful discriminatory reason, such as race, gender, national origin, disability, age or religion. This policy also prohibits actions that, while they may not be so severe or serious as to constitute harassment in a legal sense, are nevertheless commonly understood to be abusive and disrespectful of others. Accordingly, slurs, jokes, or remarks that are derogatory of a person or group’s race, ethnic background, religion, gender, disability, sexual orientation, economic status, or age are considered inappropriate for the Academy’s environment.

I've read the above and agree.

Social Media Policy Agreement

Ballet Pensacola encourages all staff, Company Members, students and faculty to engage with, and create
content for, Ballet Pensacola's Academy social media pages. All active social media participants, directly or indirectly representing the Ballet Pensacola brand, should be aware that Ballet Pensacola reserves the right to request the immediate removal of and /or block content or followers that in any way relates to Ballet Pensacola, or the activities herein.

I've read the above and agree.

Photo and Media Policy Agreement

I hereby give permission to Ballet Pensacola's Academy to use my child’s photographic likeness (produced by Ballet Pensacola's Academy) during his/her period of tenure in all forms and media for advertising, trade and any other lawful purposes. I understand that said likeness will continue to be the property of Ballet Pensacola's Academy after my child’s tenure

I've read the above and agree.

Withdrawal Policy Agreement

Should a parent desire to withdraw a student prior to the end of the year, the Academy must receive written notice stating the student's name and the date that the student will officially withdraw from the program. THE PARENT OR GUARDIAN WILL BE RESPONSIBLE FOR ALL TUITION PAYMENTS DUE UNTIL THE DATE THE ACADEMY OFFICE RECEIVES NOTICE OF WITHDRAWAL IN WRITING FROM THE PARENT OR GUARDIAN. Verbal notification of withdrawal will not be accepted. Student withdrawals will be finalized after a parent or guardian completes the Student Withdrawal Form.

I've read the above and agree.

Payment Policy Agreement

Annual tuition is divided into 10 equal monthly payments. Monthly tuition payments are due on the first of the month. Accounts with payments received after the 10th of each month will be assessed a $10 late fee for that month. Late fees will be strictly enforced. Students with delinquent accounts may not be allowed to participate in class or any performances. Returned checks will be assessed a $20 fee. Annual tuition paid in full at the start of the season will receive a 5% discount. Please call the Ballet Pensacola Office with any special arrangements or questions regarding tuition payments.

I've read the above and agree.

I Agree to All of the Above

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