Adapted Dance Off-Site Registration for 2020-21 (Virtual)
Adapted Dance - Offsite takes existing Houston Ballet Education and Community Engagement programs and adapts them to populations with specific needs: such as down syndrome, autism, and the like. Our specially trained staff partners with schools, hospitals, and other organizations to create a program specifically designed for your students.
Adapted Dance - Off-Site is perfect for your SLC, SLL, and SPED classes.
• This is a FREE program conducted LIVE via Zoom, Teams, or Skype.
• Class length will vary depending upon student needs.
• Campus teachers are expected to maintain online management and attendance.
• Requests are filled on a first come, first served basis, and are subject to availability.
• You will be contacted to confirm date, time and number of sessions.
* Required
LOCATION INFORMATION
Is your school or organization part of any of the initiatives or partnerships listed below?
*
(Please check all that apply)
Arts Connect
BakerRipley
Chavez High School Feeder Pattern
HISD's Achieve 180
Mayor Turner's Complete Communities
My Brother's Keeper
ProUnitas
Ronald McDonald House Charities
None of the above.
Required
Full name of school or organization
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip Code
*
Your answer
School District
If applicable
Your answer
PRIMARY CONTACT INFORMATION
First Name
*
Your answer
Last Name
*
Your answer
Title
*
Your answer
E-Mail
*
Your answer
Direct Telephone Number
Your answer
SECONDARY CONTACT INFORMATION
We will contact this person if the primary contact is unavailable.
First Name
Your answer
Last Name
Your answer
Title
Your answer
E-Mail
Your answer
PROGRAM INFORMATION
Grade Level or Age Range
*
Your answer
Number of Students
*
Your answer
What special need(s) is your program, school, or organization addressing?
*
Your answer
What month/s are you interested in receiving classes?
*
Please select all that apply. We will do our best to accommodate.
January
February
March
April
May
June
Any month. We are flexible.
Required
What day(s) do you prefer?
*
Check all that apply. We can see students up to 3x a week.
Monday
Tuesday
Wednesday
Thursday
Friday
Any Day. We are flexible.
Required
What time do you prefer we start class?
*
Please be specific, ex. 9:00 AM-12:00 PM CST.
Your answer
This program requires a live video platform. Which platform works best for you?
*
Select all that apply.
ZOOM
Microsoft Teams
Skype
Other:
Required
Would you like to add any NOTES that can better assist us with booking your request?
Your answer
Would you like to be enrolled in the Education and Community Engagement e-mail list?
*
Choose
Yes, sign me up!
I'm already enrolled
Not at this time
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