2020 SUMMER REGISTRATION
Student Name
First Name
Last Name
Parent Name
First Name
Last Name
Parent Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email
example@example.com
Age
Date of Birth
-
Month
-
Day
Year
Male
Female
Pointe
Dance History (schools and years studied)
I am registering for
Pre-Ballet
Beginning
Intermediate
Advanced
Adult
Number of weeks
1
2
3
4
5
I understand that the Zamuel Ballet School is not responsible for accidents or injury that may occur on Zamuel Ballet School premises, or during organized rehearsals or performances at theaters or other locations. I also understand that photos may be taken of students during Zamuel Ballet School events. I give permission for the above student's likeness to be used in Zamuel Ballet School materials. Check payable to Zamuel Ballet School. We also accept major credit cards.
I agree
I do not agree
Submit
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