South Lane Ballet Academy Registration 2019/2020
Physical address - 308 S 10th Street Suite B, CG OR, 97424. Mailing address - P.O. Box 1299. 541-912-2080.

Please choose the class(es) you think best suits your experience level as well as interest. Classes are listed by style, then in order by level / age. If we feel you have registered for a class that isn't suitable, we will email you to help you find an alternative.

If a class fails to reach 5 participants, it may be closed due to low enrollment

Monthly tuition -
Mini class - $30 (any 30 minute class)
1 regular class - $45
2 regular classes - $85
3 regular classes -$120
4 regular classes - $150
Unlimited for an individual - $150
5 regular classes - $180
6 regular classes - $205
7 regular classes - $225
8 regular classes - $240
Unlimited family - $250

Please remit the $40 registration fee to SLBA within 10 days of registration. You can send it to the physical address above, or via PayPal through the email address above. If you have an outstanding balance, we will not allow you to re-register until it is cleared up. Thank you!
Student Name
Your answer
Your answer
Your answer
Parents name
Your answer
Home phone, Work phone, Cell phone
Your answer
Email Address (must be included to be a valid registration)
Your answer
Emergency Contact phone number (other than parent)
Your answer
Emergency Contact's Relationship to Dancer
Your answer
Primary Care Physician Name & Phone number
Your answer
Insurance Company & Policy Number
Your answer
Special notes regarding dancer: (behaviors, medical, injury, or safety concerns, etc)
Your answer
Adult Classes
Hip Hop
By printing my name below I certify that all the information submitted is accurate & true. I also agree to the financial obligations associated with taking classes at SLBA (We do not offers refunds without a doctor's note saying you are unable to finish classes). By submitting this form, I also understand that my child's spot is not officially reserved until the $40 annual registration fee is received. Registrations will be deleted if payment is not received within 10 days of registration.
Your answer
May your dancer be photographed for SLBA marketing / promotions
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