Minnesota Ballet School Drop-In Class Registration Form

Please call 612.501.9208 or e-mail to minnesotaballetschool@gmail.com
to check class availability prior to registering for any drop-in classes.

Is the student registering an adult or a child?

AdultChild

Parent/Guardian 1*

First NameLast Name

Relationship to Student*

Primary Phone*

Area CodePhone Number

e-mail*

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Emergency Contact (If Parent/Guardian cannot be reached)*

Emergency Phone*

Area CodePhone Number

How did you hear about us?

Referral Name

First NameLast Name

Billing Information differs from Parent/Guardian Information

Please note: Parent/Guardian listed above assumes primary responsibility for account maintenance. Billing Info is for contact information only.

Billing Name*

First NameLast Name

e-mail*

Primary Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student Name*

First NameLast Name

Student Gender*

Date of Birth*

MonthDayYear

Age

Grade in School 2024-2025

School

Student email

Student Cell Phone

Area CodePhone Number

Choose your preferred option:*

In-PersonVia ZOOM

COVID-19 Vaccinated*

YESNO

MASK REQUIRED

Class 1*

Class 1 Cost

Class 2

Class 2 Cost

Class 3

Class 3 Cost

Class 4

Class 4 Cost

Class 5

Class 5 Cost

Grand Total

5%

5% convenience fee will be added to all credit card payments. We will make any necessary corrections and bill your account. Payment and a current account is required to secure a place in each class. Class sizes are limited.

Notes:

Today's Date

Date

Acknowledgement of Risk and Waiver of Liability

I acknowledge and understand that by participating in studio classes, events, and activities organized by The Minnesota Ballet Theatre and School, I am waiving any liability of the school and its staff for any injuries that may occur, including but not limited to those incurred during travel to and from training sessions or other scheduled activities.
In the event of an injury, I authorize and give consent for emergency medical care to be provided by ambulance or hospital personnel for myself or my child(ren).
I am fully aware of the contagious nature of COVID-19 and hereby voluntarily assume the risk of potential exposure or infection by attending activities at the Minnesota Ballet Theatre and School. I understand that such exposure may result in personal injury, illness, permanent disability, and even death. I also acknowledge that the risk of exposure to COVID-19 and other contagious diseases and viruses may arise from the actions, omissions, or negligence of myself and others.
Furthermore, I agree to indemnify and hold harmless The Minnesota Ballet Theatre and School, its staff, agents, and employees from any and all claims of liability for personal injury, including injuries resulting in death, as well as damage to my property, my child(ren)'s property, or the property of other family members. This release of liability and indemnification applies to all classes and activities associated with the Minnesota Ballet School program.

Photo and Video Waiver of Liability

I confirm my authorization and grant permission for the recording of my own or my child picture and voice on photographs, films, and tapes. I am aware that Minnesota Ballet Theatre & School holds the right to edit these recordings at their discretion and incorporate them into movie and sound films, tapes, radio or television broadcast programs.
Furthermore, I consent to the usage of these recordings by the Minnesota Ballet Theatre & School for promotional displays, advertising purposes, and dissemination on various social media platforms, including but not limited to Facebook, Twitter, Instagram, and the official Minnesota Ballet Theatre and School website.
I acknowledge that Minnesota Ballet Theatre & School does not make any promises of compensation for the aforementioned use.
Additionally, I understand that all photographs and videos taken by the Minnesota Ballet School are the sole property of the school. By proceeding with this agreement, I affirm that I have thoroughly read and comprehended the terms outlined in the Publicity Release.

Please designate preferred hospital in case of emergency.*

Check the box to agree with terms and conditions above*

I Agree

Payment*

Cash/CheckCredit Card

Total Payment*

USDDescription

Credit Card

MBS Drop-in/Trial Class Registration Form

Parent/Guardian Info

Referral Info

Billing Info

Student Info

Totals

Terms and Conditions

Acknowledgement of Risk and Waiver of Liability

Credit Card