Angelina Ballerina Registration Form 2024

July 2nd-30th 2024

Every Tuesday and Thursday starting July 2nd (with the exception of July 4th). Last class is Thursday, July 30th.

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Camp Tuition - $125.00 Per Child.

Total of 8 Classes during July:

7/2, 7/9, 7/11, 7/16, 7/18, 7/23, 7/25, 7/30

10:00am-11:00am - 3-4 year olds.

11:00am-12:00pm - 5-6 year olds.

Please fill out one form for each child.

If you wish to register for the full school year, please fill out our registration form for the school year 24/25.

Parent/Guardian Name*

First NameLast Name

Child's Name*

First NameLast Name

Child's Age*

Child's Birthdate*

Date

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Primary Contact Phone Number*

Please enter a valid phone number.

Primary Contact Email*

example@example.com

Billing Contact Name - Responsible for Payment*

First NameLast Name

Billing Contact Email*

example@example.com

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

Would you like to Receive Fall 2024 class registration information?*

YesNo

Would you like to pay the $125.00 fee now?*

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

Camp Fee Calculation

Angelina Ballerina Camp Fee

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*

Angelina Ballerina Camp 2024 Registration Form

Credit Card