IBC Summer Intensive 2025 Registration Form

IBC Summer Intensive 2025 Registration Form

June 9-13, M-F: Levels 2/3 Ages 5-8, 3:00-4:00, $150 ~ Level 4 Ages 9-12, 6:30-8:00, $250 ~ Level 5/6 Ages 13+, 4:00-6:30, $400
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Previous Ballet Training Experience
Please list the number of years of ballet training, where you trained in ballet, and the number of years on pointe.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact/Parent/Guardian Name
Contact/Parent/Guardian E-mail
example@example.com
Contact Mobile Number
Contact Work Number
Emergency Contact Name
Emergency Contact Number
List Medical Conditions and Instructions in Case of Emergency or N/A
Policy and Procedure
Liability Waiver
Guardian/Parents Signature in Agreement to Liability Waiver and Policy and Procedures Terms*

Clear
GUARDIAN/PARENT OF PARTICIPANT HAS CAREFULLY READ THESE TERMS OF AND FULLY UNDERSTANDS THEIR CONTENT AND IS AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN PARTICIPANT OR GUARDIAN/PARENT OF PARTICIPANT AND THE RELEASEES AND SIGNS IT OF HIS OR HER OWN FREE WILL.
Participant Signature in Agreement to Liability Waiver and Policy and Procedures Terms*

Clear
PARTICIPANT HAS CAREFULLY READ THE ABOVE ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT TERMS AND FULLY UNDERSTANDS THEIR CONTENT AND IS AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT BETWEEN PARTICIPANT AND THE RELEASEES AND SIGNS IT OF HIS OR HER OWN FREE WILL.
After registration you will be contacted via email with information about the program a week before classes begin. Contact Victoria Stocki at victoriastocki@internationalballetconservatory.com with questions.
Registration Fee
prevnext( X )
USDRegistration Fee
Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty: