Hariyama Ballet Summer Registration

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Kids Summer 2021, Junior Summer 2021

Student Name *

Student's DOB *

YYYY

Parent Phone number *

Students email address (Not required)

Which level is the student? *

Kids Pink (Age 5 and up for Summer Camp)

Kids Blue (Age 7 and up)

Pre Junior (Age 9 and up)

Junior 1-2 (Depending on experience and age)

Junior Advanced (Depending on experience and age)

Zoom or Studio *

Zoom

Studio

I want to Mix

Required

Which one is your choice ? *

<1> Kids Full Summer Camp

<2> Kids Summer Camp weekly

<3> Kids Ballet / Variation Camp for 4 weeks

<4> Kids Ballet / Variation Camp weekly

<5> Kids Non Ballet Camp

<6> Non Ballet Camp weekly

<7> Kids Ballet / Variation Set by Day, 1 set per week

<8> Kids Ballet / Variation Set by Day, 2 sets per week

<9> Kids Ballet / Variation Set by Day, 3 sets per week

<10> Junior Full Summer

<11> Junior Summer Weekly

<12> Junior Ballet & Variation only for Full Week

<13> Junior Ballet & Variation only for Weekly

<14> Junior Ballet / Variation Set, 1 set per week

<15> Junior Ballet / Variation Set, 2 sets per week

<16> Junior Ballet / Variation Set, 3 sets per week

Option 17 - Add Weekend Ballet

Option 18 - Add Weekend Stretch

<19> Weekend Class Only, $120 for Ballet / July

<20> - Weekend Stretch Only, $70 for Stretch / July

<New> Pick a day from Monday - Saturday

Other:

Required

Please choose week or days *

FULL 4 WEEKS

Week 1 : July 5th - 9th

Week 2 : July 12th - 16th

Week 3 : July 19th - 23rd

Week 4 : July 26th - 30th

Add Weekend Ballet

Add Weekend Stretch

Monday Ballet / Variation Set

Tuesday Ballet / Variation Set

Wednesday Ballet / Variation Set

Thursday Ballet / Variation Set

Friday Ballet / Variation Set

Weekend Ballet Only

Weekend Stretch Only

Pick a Day (Please list which day you pick in the comment area)

Required

Interested in assisting Kids Classes? (For Junior)

Yes

Clear selection

Choose your Payment method. *

Venmo

Paypal account to Paypal account

Credit payment through Paypal (3% fee will apply)

Quick survey for August. Would students take classes?

Yes, in the morning

Yes, in the afternoon

Yes, on the Weekend

I can not take classes.

Other:

Any request or comment?

Please read cancel policy and check "Agreed". Cancellation Policy. No refunds will be made. In cases of long-term health problems or injury, a school credit may be considered if your child is unable to attend class due to extenuating circumstances. We may request a note from a physician or health care provider describing the illness or injury. There after we will consider crediting part of the tuition. This credit is applicable towards future school classes only. All classes are subject to cancellation dependent upon student enrollment.

Agreed

Please read below. Checking the box here means you agree with our guidance and policy. “The risk of injury exists in any physical activity. Please consider this before enrolling your child. Hariyama Ballet cannot be held responsible for personal injury during any classes.” To prepare for Zoom classes, please move furniture or any items that might be dangerous for taking dance classes. Please keep little ones or pets where safe from dancing. If the floor is hard surfaces, students should use a mat like a Yoga mat to take class to prevent injury to their joints. We are doing our best to provide safety for the studio classes, therefore we can not take any responsibility for the sickness. *

Agreed

Required

Digital Signature. Please type your name (who is responsible for the child) and date. *

Submit

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