2020-2021 Academy Registration Form
Registration form for Oakland Ballet Company's Academy.

Please complete one registration form for each student you would like to enroll.

Tuition Payments can be made in one of three ways.
mail us a check made out to the Oakland Ballet Company 2201 Broadway Suite LL17, Oakland, CA 94612
call us to process a credit card at 510-893-3132
or use the following PayPal link
https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=74J2SJX3LWL2A

If you are enrolling in the middle of a semester, your tuition will be pro-rated based on the number of classes left in the year.
Student First Name *
Student Last Name *
Class Level Requested *
Student Age *
Student Birth Date *
Parent First Name *
Parent Last Name *
Email Address *
Note that you will primarily be contacted by email. If this is problematic, please make a note that you would like to be contacted by phone only.
Phone Number *
Please provide the number you prefer to be contacted at.
Street Address *
City *
State *
Zip Code *
Emergency Contact and Relationship *
Emergency Contact Number *
Dance Training to-Date *
RELEASE OF LIABILITY AND INDEMNIFICATION: I, on behalf of myself/minor child and my heirs, guardians, personal representatives, or assigns, do hereby release, indemnify and hold harmless the Oakland Ballet Company, including but not limited to its employees, agents, and Board of Directors from any and all liabilities, claims, demands, and causes of action, of any kind arising out of or relating to any personal injuries (including death) and property losses or damages that may be sustained by me or my minor child in connection with any activities occurring in the studio when engaging in dance classes with the Oakland Ballet Company, or with any activities occurring in my own home or premises, or any other location I choose when engaging in remote learning opportunities with the Oakland Ballet Company. I have voluntarily chosen to participate or allow my minor child to participate in dance training either virtual or in studio offered by the Oakland Ballet Company. I am aware that dance training and related activities carry certain risks that can result in injury, both minor and major, and I am fully aware of the risks and hazards involved. It is further acknowledged that the Oakland Ballet Company does not provide medical insurance. Each family must provide their own coverage. By my signature below I confirm that I have read the above Release of Liability and Indemnification and fully understand its contents. I understand that I may seek legal counsel before signing this Release of Liability and I knowingly and voluntarily agree to the terms and conditions as stated above. *
By typing my name below, I am legally accepting the OBC Release of Liabiity and Indemnification.
MEDIA RELEASE: As a student training and/or performing with Oakland Ballet Company, I hereby irrevocably consent to release all rights to photographs, videotapes, or other recordings of me taken by Oakland Ballet Company during classes, rehearsals, and/or performances. All negatives and positives together with any and all prints now and in the future shall constitute Oakland Ballet Company's property solely and completely. I understand that I may not videotape any classes, performances or rehearsals without prior consent. *
By typing my name below, I am legally accepting the OBC Media Release.
Date *
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