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CBA Registration: 2019-2020
Please complete a registration form for each child. Non-refundable tuition is due by the first day of class each semester.
Student Information
Last Name *
Your answer
First Name *
Your answer
Date of Birth *
Month/Day/Year
Your answer
Academic Grade *
(for 2019-2020 school year)
Academic School *
Your answer
CBA Class Information
What CBA level was this student in during the 2018-2019 year? *
What CBA level is the student registering for? *
Select all that apply. Please refer to the website for 2019-2020 class schedules.
Required
Advanced Class Students: Additional Information
This question is ONLY for students in the Advanced level. If registering for less than 5 days per week, please include the day(s) you plan to attend in the Notes section of this form then contact us for tuition information.
Parent/Guardian Information
Parent/Guardian's Name *
Your answer
Additional Parent/Guardian's Name
Your answer
Street Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Primary Phone Number *
Your answer
Alternate Phone Number
Please include an additional contact number if applicable.
Your answer
Email Address *
Your answer
Secondary Email Address
Please include any additional email addresses you would like information to be sent to.
Your answer
Emergency Contact Information
Name *
Your answer
Phone *
Your answer
Additional Information
I am interested in going paperless and receiving the majority of CBA communications electronically:
Are you interested in volunteering in any of these areas?
Please select all that apply:
How did you hear about CBA?
Optional question for new students.
Notes
Use this space to include additional information you'd like to share (ex: allergies, medical info, preferred pronouns, etc.).
Your answer
Waiver
I hereby release Chicago Ballet Arts, its agents and employees, from all liability for personal injury, illness, or property loss or damage. I give consent for staff and personnel to take and use photographs and/or video of my child for CBA's promotional purposes, including for use on its website, social media, posters and other materials.
By checking this box I have read and agree to the above waiver and understand that this will serve as my electronic signature. *
Required
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