Admission Form
Welcome to The School of Classical Ballet and Western Dance! We are pleased to have you join us. It is important for us to have your details for our records. We request you to fill this form and submit it to us by the given date. Please write 'Not Applicable' OR 'NA' in case of no response. Thank you for your time and cooperation.
STUDENT INFORMATION
Name
*
First Name
Last Name
Student Admission Status
*
New Student
Returning Student
Existing Student
Admission Secured in Ballet School
*
-
Month
-
Day
Year
Date
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
Gender
*
Female
Male
Non Binary
Prefer not to say
Email
*
example@example.com
Student Phone Number (If any)
-
Area Code
Phone Number
Residential Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student's Academic School Name
*
Academic school timings
*
Academic school holidays ( Please share the months of your child's summer, Diwali and winter holidays)
*
Location of preference for classes
*
South Mumbai
Bandra
Either of the above
Instagram Handle of Student (if any)
Facebook Handle/ link of Student (if any)
Student's Passport Size Photo (Kindly upload a png or jpg format photo, less than 1 GB in size)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
PARENT INFORMATION - MOTHER
Name
*
First Name
Last Name
Mobile Number
*
-
Area Code
Phone Number
Alternate Phone Number (if any)
-
Area Code
Phone Number
Mother Email ID
*
example@example.com
Organisation Name and Occupation
*
Please write 'Not Applicable' OR 'NA' if not relevant to you
Instagram Handle of Mother (if any)
Facebook Handle of Mother (if any)
PARENT INFORMATION - FATHER
Name
*
First Name
Last Name
Mobile Number
*
-
Area Code
Phone Number
Alternate Phone Number (if any)
-
Area Code
Phone Number
Father Email ID
*
example@example.com
Organisation Name and Occupation
*
Please write 'Not Applicable' OR 'NA' if not relevant to you
Instagram Handle (if any)
Facebook Handle/ Link (if any)
PARENT INFORMATION - GUARDIAN
Name
*
First Name
Last Name
Mobile Number
*
-
Area Code
Phone Number
Email
*
example@example.com
ADDITIONAL INFORMATION
How did you hear about our school?
*
Google Search
Instagram
Facebook
Word of Mouth
Other
If your answer for the above question is 'Word of mouth' or 'Other', please let us know about your source of information
Please list prior dance experience in Ballet if any (i.e. number of years, technique studied, school/ teachers who taught them, etc.)
*
Please write 'Not Applicable' OR 'NA' in case of no prior Ballet experience
Please list prior dance experience in any other dance form (i.e. number of years, technique studied, school/ teachers who taught them, etc.)
*
Please write 'Not Applicable' OR 'NA' in case of no prior dance experience
Please let us know if the student is training in any other dance form or attending any other dance classes
*
RELEASE AND AUTHORIZATION OF STUDENT MEDICAL INFORMATION
Please list down any health problems (physical and/or mental) that the student may have
*
I further certify that the aforementioned student is physically and mentally fit to participate in the exercise/dance program
*
Yes, I certify the above
EMERGENCY INFORMATION
Physician Name
*
First Name
Last Name
Physician Number
*
-
Area Code
Phone Number
Student Blood Group
*
Additional Information/Comments
*
This would include previous or current injuries, any regular or SOS medication taken. Please write 'Not Applicable' OR 'NA' in case of no response.
STANDARD RELEASE AND CONSENT FORM
As a parent or guardian of this student, I hereby grant permission to the School to use her/his/their name, photographs, videos, quotes taken during her/his/ their time with the school for publicity, promotional activities (of the school) and/or educational purposes in publications, presentations or broadcast via newspapers, online portals or any other possible communication and media sources. Further to this, the photos can be used for an indefinite period. I do this with full knowledge and consent and waive all claims for compensation for use of the said photos, videos, or quotes.
*
Yes, I give my consent
No, I do not give my consent
CONSENT FOR PHYSICAL CLASSES
I hereby declare as under: ● I consent to my ward attending physical classes ● I declare that my ward is not exhibiting any symptom of COVID-19 like fever, cough, shortness of breath, sore throat, body ache or an upset stomach/ diarrhoea today or during the last one week. Neither has anyone in my household. ● I/my child has not, to my knowledge, been in contact with anyone who was or turned out to be COVID positive. Neither has anyone in my household. ● I declare that my ward will follow all safety & hygiene guidelines ● I hereby declare that the above information is true and correct to the best of my knowledge. I understand that: (a) If any of the above requirements are not satisfied, my child will not be permitted to attend school until the relevant requirement is met. (b) While all reasonable measures and precautions are being taken by the school to ensure children's health and safety, my child is attending the school at their own risk. (c) The school assumes no liability or responsibility with respect to any COVID-related or other illness or incident
*
Yes, I consent to the above
No, I do not give my consent to the above
I have read all the terms and conditions sent via email and agree to all of them. I hereby declare that all the information provided above is true to the best of my knowledge and belief.
*
Yes
No
Please upload a scanned image of your name, signature/ initials, along with the date. Alternatively, you can type your full name in the section below which will be taken as your sign off on the information provided above.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Name and Signature
*
Continue
Continue
Should be Empty: