Poise Ballet Registration Form
Please complete this form to enroll your child for classes in school year 2020–2021 (classes begin on August 17, 2020, and end on June 11, 2021). We accept new students on a rolling basis! If you have a question about our classes or enrollment, please use our Contact Form via this link: http://www.poiseballet.org/contact.html. Thank you for your interest in Poise Ballet! ♡
Would you like to have a Free Trial Class?
STUDENT INFORMATION ☆
Student Name (First, Last) *
Preferred Nickname (if applicable)
Age *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Academic School *
Grade as of Fall 2020 *
PARENT INFORMATION ☆
Primary Parent Name (First, Last) *
Mailing Address (Street, City, State, Zip) *
Email *
Best Phone Number *
Alternative Phone Number
Additional Parent / Guardian to contact in case of an emergency
Additional Parent / Guardian's Best Phone #
CLASS REGISTRATION ☆
BALLET CLASS REGISTRATION
Please choose which ballet class you're enrolling your child in. Note: * (asterisk) requires prerequisite, or previous dance experience.
FREQUENCY
How many times a week will they attend class?
AUXILIARY CLASSES (not available at this time)
Not available at this time. These supplement the above classes, and take place on Saturdays.
For SUMMER DANCE CAMP Students: NO SUMMER CAMP currently
Choose TWO from the following options: 1) which Camp and 2) which dates your child will participate in OR Choose NON-APPLICABLE if registering for the Fall.
PREVIOUS DANCE TRAINING & EXPERIENCE ☆
Has your child taken ballet classes before? *
If YES, at which school and for how long?
Any training in other forms of dance?
MEDICAL HISTORY ☆
Allergies that Poise Ballet should be aware of: *
Required
Does your child have an illness that requires constant medical follow up? *
If YES, please specify the nature / reasons of their medical follow up:
Does your child have any of the following conditions: *
Required
If yes, please specify the nature of the condition:
Has your child had any of the following: *
Required
I have read Poise Ballet's Policies & Procedures and agree to them. *
Required
Additional comments (optional)
How did you hear about Poise Ballet? *
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