Registration for Neglia Ballet's FREE Summer Boys Program "Boys Dance Too!"
This all-boys program runs Monday - Friday from June 24 - July 5, 2019 (excluding July 4th) from 4:30 pm - 5:30 pm

By submitting this form you are agreeing to the full terms of the program which include full participation for the 2 weeks, punctual arrival and departure, and that the participant has a strong interest in ballet.

While the program is tuition-free, participants are required to submit the $30 registration fee which will be applied to the 2019-2020 Conservatory year should they decide to continue with ballet classes at Neglia.

Email address *
Student Name *
last name, first name
Your answer
Student Birthdate (MM/DD/YYYY) *
Your answer
Age as of June 24, 2019 *
Your answer
Current Academic School *
Your answer
Grade in School *
Your answer
Why does your son want to participate in the boys summer ballet program? *
Your answer
List previous dance experience if applicable. *
Dance experience is NOT needed to participate in this program. If your son has not danced before, please enter "none". If your son has had dance experience please include the style of dance, and the studio / school where he took class.
Your answer
Please list any handicaps, allergies, disabilities, or chronic illnesses including nervous, or emotional conditions that might affect study. *
If not applicable enter "none"
Your answer
Parent/ Guardian #1 *
Your answer
Cell Phone Number of Parent/ Guardian #1 *
(xxx) xxx-xxxx
Your answer
Email of Parent/ Guardian #1 *
Your answer
Parent/ Guardian #2
Your answer
Cell Phone Number of Parent/ Guardian #2
(xxx) xxx-xxxx
Your answer
Email of Parent/ Guardian #2
Your answer
Street Address *
Address of where the student resides
Your answer
City/ Town of Residence *
Your answer
State of Residence *
Your answer
Zip Code *
Your answer
Emergency Contact *
Name and Phone Number (other than previously listed parent/ guardian)
Your answer
Ethnic/ Racial Background *
Beneficiary statistics required by Erie County and Other Funders. Information on this form is confidential. Statistics are only reported in aggregate/total. Please check the appropriate box.
Gross Family Income *
Beneficiary statistics required by Erie County and Other Funders. Information on this form is confidential. Statistics are only reported in aggregate/total. Please check the appropriate box.
How did you hear about Neglia's Boys Summer Program? *
Briefly describe where or from whom you heard about the program. (School Teacher, Flyer, Facebook, Newspaper, Neglia Newletter or website...)
Your answer
If your son has the interest to pursue training in dance, will your family be supportive of the required amount of hours recommended by the Neglia Staff? *
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