Rothesay Ballet School & Gala Ballet Productions Online Registration

Registration

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Welcome to Rothesay Ballet School! We are very excited that you are joining the RBS family! Please complete the following registration form. If you have any questions please be sure to check our website at www.rothesayballetschool.com or email info@rothesayballetschool.com.

* 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*

New Brunswick*

Postal Code*

Primary Phone*

Additional Info

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

Contact #1

Contact #1 First Name*

Last Name *

Type*

How Can We Contact You?

Home Phone

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?

Home Phone

Work #

Cell #

Email (Emails are kept confidential)

Confirm Email

Student #1

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Please indicate NONE if your child does not have any allergies)*

Medications (Please indicate NONE if your child has no medications of concern)*

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

Enroll in Classes

Select Class *

Student #2 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Please indicate NONE if your child does not have any allergies)*

Medications (Please indicate NONE if your child has no medications of concern)*

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

Enroll in Classes

Select Class *

Student #3 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Please indicate NONE if your child does not have any allergies)*

Medications (Please indicate NONE if your child has no medications of concern)*

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

Enroll in Classes

Select Class *

Student #4 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Please indicate NONE if your child does not have any allergies)*

Medications (Please indicate NONE if your child has no medications of concern)*

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

Enroll in Classes

Select Class *

Student #5 (Show-Hide Details)

Student's First Name*

Last Name*

Birth Date*

Additional Info

Grade Level*

Special Needs (Leave blank if NONE)

Allergies (Please indicate NONE if your child does not have any allergies)*

Medications (Please indicate NONE if your child has no medications of concern)*

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

Enroll in Classes

Select Class *

Add Another Student

Required Policies

(Show-Hide Details)

Questions or Concerns

Comments

Payment Information

Account Information

Montly - or - Pay in Full*

Credit Card

Card Number *

Exp Month *

Exp Year *

Card Nickname

Name as it appears on card *

Address Line 1

Address Line 2

Country *

City

New Brunswick*

Postal Code*

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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)

I Agree to All of the Above

Questions or Concerns

Payment Information

Account Information

Credit Card

Required Policies

(Show-Hide Details)