Date of Registration *

Name of Student *

Students Date of Birth *

Students age 8/1/20 *

Parent's Name *

Email address *

Home Address *

Phone Numbers *

Emergency contact name and phone number *

Please let us know where your child will be going to school and the grade entering August 2020. *

Are there allergies we need to be aware of regarding this student? *

Does student have previous injuries we need to be aware of? *

Has your child had previous dance experience? Name of school, style of dance (Ballet, Tap etc.) and number of classes per week? *

Is this student on pointe? How long has she been on pointe? *

Please let us know the classes you are registering.

After submitting this form you will receive an invoice via email and will be able to pay the balance due online. How would you like to pay? *

The East Tennessee Youth Ballet is the performing company of East Tennessee Ballet Academy. While students are welcome to perform in ETBA's annual Nutcracker and the End of Year 'Academy Gala', your dancer may want to consider joining the Youth Ballet. Information about the East Tennessee Youth Ballet can be found at etballetacademy.org.