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2023 BALLET ARTS REGISTRATION FORM
CHILD Last Name
CHILD First Name
Date of Birth
Age (as of Sept. 1)
School & Grade
Mom Cell Phone
Dad Cell Phone
Student Cell Phone
Financially Responsible Name (if different from above)
Financially Responsible Email
Medical Condition(s) To Be Aware
Emergency Contact - Not Parent (name/number)
Prior Dance (place & years)
I have dance continually at Ballet Arts for how many years
I give my permission to process any payments made by check or chredit card through he check and credit card processing terminal and the bank and I understand, if a check is found to have insufficient funds, there is a penalty fee tha must be paid to Ballet Arts of $20.00. If this sectin is not signed, te all payments must be cash only. Please Sign
I have read and understand the policies in the Ballet Arts manual and agree to abide by them.
I give mypermissio for any photo or video usage.
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