Poise Ballet Registration Form
Please complete this form to enroll your child for classes in school year 2019–2020 (classes begin on September 3, 2019, and end on June 19, 2020). 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:
. Thank you for your interest in Poise Ballet! ♡
Would you like to have a Free Trial Class?
If YES, please use our Contact Form:
If NO, please fill out our registration form...
STUDENT INFORMATION ☆
Student Name (First, Last)
Preferred Nickname (if applicable)
Date of Birth
Grade as of Fall 2019
PARENT INFORMATION ☆
Primary Parent Name (First, Last)
Mailing Address (Street, City, State, Zip)
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.
Pre-School (3 - 4.5+ yrs old)
Pre-Primary (5+ yrs old)
Primary (6+ yrs old)
Grade 1 (7+ yrs old)
Grade 2 (8+ yrs old)*
Grade 5 (11+ yrs old)*
How many times a week will they attend class?
Once / week
Twice / week
Three times / week
AUXILIARY CLASSES (not available at this time)
Not available at this time. These supplement the above classes, and take place on Saturdays.
Contemporary (Sat) from 11:00am-12:15pm (6+ yrs old)
Lyrical Jazz 2 (Sat) from 12:15-1:30pm (10-18 yrs old)
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.
Summer Dance: FUN Camp
Session 1: July 11th - 15th
Session 2: August 1st - 5th
Summer Dance: INTENSIVE Camp
Session 1: July 18th - 22nd
Session 2: August 8th - 12th
NON-APPLICABLE (Regular Session student)
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?
Jazz / Lyrical Jazz
Hawaiian / Tahitian
MEDICAL HISTORY ☆
Allergies that Poise Ballet should be aware of:
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:
If yes, please specify the nature of the condition:
Has your child had any of the following:
Hospitalization that required 5+ days of stay
I have read Poise Ballet's Policies & Procedures and agree to them.
Please read on our website:
Yes, I agree.
Additional comments (optional)
How did you hear about Poise Ballet?
Poise Ballet Staff (teacher, admin, etc.)
Current Poise Ballet Student
Social Media (Facebook, Instagram, Yelp, Twitter, etc.)
One of our neighbors in Tamal Plaza (e.g. Andrew's Camps, The Cave, Fuse Music)
Word of Mouth
Other option not listed
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