Summer Intensive 2024 Registration Form

June 10th-28th, 2024

$100.00 Deposit due June 1st, 2024

For dancers 7 yrs. and up.

For more information, please visit KingsportBallet.org or email us at KingsportBallet@gmail.com

NOTE: EXACT HOURS ARE SUBJECT TO CHANGE - DATES WILL REMAIN THE SAME.

Non-KB students, please send us a 10min audition video to Kingsportballet@gmail.com or contact us to arrange an evaluation in-studio to determine your group.

Dancer Name*

First NameLast Name

Dancer Age*

Submission Date

Date

Years of Pointe

Age Calculation

Is the student enrolled at Kingsport Ballet?*

YesNo

Please Enter the Name of Your Ballet School Here:*

Please Enter Your Ballet Level*

KB Ballet Level in 23/24 school year*

Will you need housing?*

YesNo

If yes, would you like us to arrange housing with a host family?

YesNo

Parent/Guardian Name (Required for Dancers 18yrs and Under)

First NameLast Name

Primary Contact Phone Number*

Please enter a valid phone number.

Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Contact Email*

example@example.com

Billing Contact Name - Responsible for Payment*

First NameLast Name

Billing Email - This email will receive the invoice for tuition. You may pay online via this e-invoice, or pay via mail with check, or pay in-person with Card, Check, or Cash.*

example@example.com

TOTAL TUITION COST WILL BE SHOWN BELOW ONCE SELECTION IS MADE. PLEASE SELECT THE APPROPRIATE GROUP/LEVEL BELOW ALONG WITH THE NUMBER OF WEEKS ATTENDING.

Please Select Group Below:*

BEGINNERS - 2 Weeks, June 10-21 (Levels BI & BII / Ages 7-10 for non-KB students, or by placement.)INTERMEDIATE (Ages 10-12 or by placement)HIGH INTERMEDIATE (Ages 11-13 or by placement)ADVANCED (Ages 13 and up or by placement)

BEGINNERS - HALF DAY 12:30-4:00pm Mon-Fri

Week 1 - June 10-14

Week 2 - June 17-21

Will the Student attend one or two weeks?*

1 Week2 Weeks

Which week?*

INTERMEDIATE - FULL DAY 10:30-4:30PM Mon-Fri

Week 1 - June 10-14

Week 2 - June 17-21

Week 3 - June 24-28

Min 2 week attendance for Kingsport Ballet Company Members or Candidates. 3 weeks highly recommended.

HIGH-INTERMEDIATE - FULL DAY 10:00-4:00PM Mon-Fri

Week 1 - June 10-14

Week 2 - June 17-21

Week 3 - June 24-28

Min 2 week attendance for Kingsport Ballet Company Members or Candidates. 3 weeks highly recommended.

ADVANCED- FULL DAY 10:00-4:00PM Mon-Fri

Week 1 - June 10-14

Week 2 - June 17-21

Week 3 - June 24-28

Min 2 week attendance for Kingsport Ballet Company Members. 3 weeks highly recommended.

Will the student attend 1, 2, or 3 weeks?*

One WeekTwo WeeksThree Weeks

Which Week(s)?*

Week 1 - June 10-14Week 2 - June 17-21Week 3 - June 24-28

Total Tuition Cost for Summer Intensive:

Total Deposit Calculation

Please Enter any additional information our instructors/staff should be aware of (Dancer Allergies/injuries, Additional Contact Info, Additional Billing Info):

$100.00 deposit is due June 1st, 2024.

Would you like to pay the deposit now?

Yes - I will pay the deposit with card now.No - I would like to receive an invoice to the billing email I provided above.

Summer Intensive 2024 Deposit

USDDescription

Credit Card

I acknowledge that I understand that participation in dance can be strenuous and challenging and could result in accidental injury. By signing below, I agree to hold harmless Kingsport Ballet and its Artistic Director, Faculty and Volunteer Staff, Board of Directors and all its contractual employees and agents in the event that my child is injured in the course of their activities and classes at Kingsport Ballet.

Signature*