Yu Xin Ballet School Registration
* All Payment must be made before class---refer to fee schedule.
* Payment by check or cash only (checks payable to Yu Xin Ballet School)
* No refunds
* $25 will be charged for a returned check

Email address *
Student Name (full name): *
Your answer
Birthdate *
MM
/
DD
/
YYYY
If under 18, parent/Guardian Name
Your answer
Address: *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Phone Number *
Your answer
Cell Phone Number:
Your answer
Email: *
Your answer
How did you learn about the class?
Your answer
Other information or anything else we should know or you want to share with us?
Your answer
Emergency contact full name: *
Your answer
Emergency contact phone number: *
Your answer
Relationship *
Your answer
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