Burklyn Ballet Virtual Registration Form 2021
Please contact us at info@BurklynBallet.com or call 1-877-287-5596 if you have any questions.
* Required
I would like to be considered for:
*
BBT Main Program: Ages 12 + up, pre-professional
Intermediate Program: Ages 10 – 12, intermediate level, no pointe work
The Choreographic Project: Ages 15 + up, with choreographic experience
To take a Master Class
Required
Audition Date
*
MM
/
DD
/
YYYY
Dancer's First Name
*
Your answer
Dancer's Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Dancer's Age on Audition Day
*
Your answer
Current Ballet School
*
Your answer
How many years have you been training seriously?
*
Your answer
Are you on pointe?
*
Yes
No
How long have you been on pointe for?
Your answer
I am currently training...
*
virtually
in person
hybrid of virtual and in person
How many hours a week have you been training?
*
Your answer
Dancer Email
*
Email address where you wish to receive confirmation and details.
Your answer
Home Address
*
Your answer
Preferred Contact Phone Number
*
Your answer
Parent #1 Name
*
Your answer
Parent #2 Name
Optional
Your answer
Parent Email
*
Email address where you wish to receive confirmation and details.
Your answer
PayPal email address of person paying the audition registration fee.
*
We will use this information to validate payment.
Your answer
Do you have a credit balance with Burklyn to apply to this season?
*
Yes
No
Waiver
*
I, the parent or legal guardian of the aforesaid student, agree on behalf of myself and said student not to hold Burklyn Ballet Theatre Inc., or the studio in which Burklyn Ballet Theatre holds its audition, the directors, faculty members or employees of either, liable for injuries or illness contracted while auditioning for Burklyn Ballet Theatre, The Intermediate Program, the Edinburgh Connection, and/or the Choreographic Project. I grant permission to Burklyn Ballet Theatre to use and display any photographs of this audition for commercial or non-commercial use. I also grant permission to Angela Whitehill, Founding Artistic Director of Burklyn Ballet Theatre, to use and display any photographs in any future publication, videos or books she might write.
I agree to the above.
Required
Dancer Electronic Signature
*
Type your name to complete your online registration form.
Your answer
Parent Electronic Signature
*
Type your name to complete your dancer's online registration form.
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
