Registration Form: July/August 2020 - Andover School of Ballet
Email address *
Student First Name *
Student Last Name *
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Parent #1 first & last name (mother) OR other emergency contact name *
Parent #1 (or other emergency contact) cell phone # *
Parent #2 first and last name (father) OR other emergency contact name *
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Student Date of Birth (Month/ Day/ Year) *
Class Options for students entering gr. 3 through Adults from July 7 - 30, 2020. Mark ALL classes in which you wish to enroll...
Please check ALL classes in which you wish to enroll ($15.00 per hour)
July 7,8,9
July 14,15,16
July 21,22,23
July 28,29,30
Tue. 5:15-6:15 pm, Jazz/Contemporary LIVE class: entering grade 7 thru Adult w/ experience
Tue. 5:15-6:15 pm, Jazz/Contemporary ZOOM ONLY: entering grade 7 thru Adult w/ experience
Tue. 6:30-8:00 pm, Ballet LIVE class (d-pte/pte for those levels): entering gr. 7 thru Adult w/ experience
Tu. 6:30-8:00 pm, Ballet ZOOM ONLY (d-pte/pte for those levels): entering gr. 7 thru Adult w/ experience
Wed. 4:30-5:30 pm, Ballet 1, 2, 3, 3+ LIVE class: entering gr. 3 thru 7: If possible, take both Wed. classes
Wed. 4:30-5:30 pm, Ballet 1, 2, 3, 3+ ZOOM ONLY: entering gr. 3 thru 7: If possible, take both Wed. classes
Wed. 5:45-6:45 pm, Modern Dance LIVE class: entering gr. 3 thru 7: If possible, take both Wed. classes
Wed. 5:45-6:45 pm, Modern Dance ZOOM ONLY: entering grades 3 thru 7: If possible, take both Wed. classes
Th. 5:00-6:00 pm, Stretch & Conditioning LIVE class: entering grade 5 thru Adult
Th. 5:00-6:00 pm, Stretch & Conditioning ZOOM ONLY: entering grade 5 thru Adult
Th. 6:30-8:00 pm, Ballet LIVE class (d-pte/pte for those levels): entering grade 7 thru Adult w/ experience
Th. 6:30-8:00 pm, Ballet ZOOM ONLY (d-pte/pte for those levels): entering gr. 7 thru Adult w/ experience
Week Long Summer Programs for ages 3.5 - 12
Summer DanceWEEK: Aug. 3-7, 2020. 9:30 am - 3:30 pm. ( entering grades 3 - 7). Tuition - $295.00 Check ALL classes in which you wish to enroll
DanceWEEK LIVE; full week: $295.00 total
M. 8/3, 3:30-5:30 pm, Extra Class; $16
T. 8/4, 3:30-5:30 pm, Extra Class; $16
W. 8/5, 3:30-5:30 pm, Extra Class; $16
Th. 8/6, 3:30-5:30 pm, Extra Class; $16
DanceWEEK LIVE; M-F, 8/3-7, 9:30-3:30 pm
Fairy-Tale Dancers, Aug. 10-14, 2020, 9:30 - 11:30 AM;. (for age 3.5 -> entering gr. 2) - Tuition $100.00 - Check ONE option only
Required liability disclaimer
I hereby enroll my child/myself in the July/August 2020 live and/or online dance programs at Andover School of Ballet.

I am aware that dance training and the exercise associated with it carry the risk of physical injury, illness or death to the participants. Additionally, I acknowledge the contagious nature of the novel coronavirus/COVID-19, and that the CDC and many other public health authorities still recommend social distancing. I further acknowledge that the Andover School of Ballet has put in place preventative measures to reduce the spread of the novel coronavirus/COVID-19. I further acknowledge that Andover School of Ballet cannot guarantee that I/my child will not become infected with the novel coronavirus/COVID-19. I understand that the risk of becoming exposed to or infected by the novel coronavirus/COVID-19 may result from the actions, omissions or negligence of myself/my child and others, including, but not limited to, dance studio staff, and other dancers and their families. I acknowledge that I/my child must comply with all set procedures to reduce the spread of the virus while attending classes at Andover School of Ballet.

I attest that; 1) I am not/my child is not experiencing any symptom of illness such as cough, shortness of breath or difficulty breathing, fever chills, shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. 2) I have not/my child has not traveled internationally within the last 14 days. 3) I have not/my child has not traveled to a highly impacted area of the United States of America within the last 14 days. 4) I do not believe that I have/my child has been exposed to a suspected +/or confirmed case of coronavirus/COVID-19. 5) I have not/my child has not been diagnosed with coronavirus/COVID-19 and not yet cleared as non-contagious by health officials. 6) I am/my child is following all CDC & state recommended guidelines as much as possible and limiting exposure to Coronavirus/COVID-19

On behalf of my child and/or myself, I assume the risk, and agree that the Andover School of Ballet, the dance instructors, and the property owners, will not be liable in any way for any injuries or illness sustained during my child’s attendance in online classes or classes in the studio. I understand that once the July/August program has begun, should the student be unable to attend for any reason, withdraw, be dismissed for cause, or be absent from the program, tuition will not be refunded.
Payment; please read:
You will receive an emailed invoice with your total to the email you provided. Your registration will be complete once payment is received. If you would like to use an alternative form of payment (ie: check), please contact Miss Kristina at kristinaasb@me.com. Your registration will not be valid without payment.
I have read and agree to the A.S.B. liability disclaimer and payment options. *
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A copy of your responses will be emailed to the address you provided.
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