New Customer Registration Form

Parent/Guardian Information:

Full Name*

First NameLast Name

Postal Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Emergency Phone Number

Area CodePhone Number

E-mail*

Confirmation Emailexample@example.com

Relationship to the Dancer*

DANCER'S NAME*

First NameLast Name

Date of Birth*

Age *

Gender*

Preferred Pronoun (e.g She/Her, He/Him They/them)*

Nationality*

Do you identify as Aboriginal/Torres Strait Islander?*

What level/class are you applying for with BTQ? *

*Please consult our 'BTQ levels aligned with Ballet Syllabus' on our website. PLEASE NOTE: Intermediate and Senior Dancers may wear pointe shoes for Ballet Repertoire, however this is not mandatory.

What MAIN Dance School do you attend?*

Name of Dance School Director/Principal?

Current Ballet Syllabus Studying *

If other, please specify

Current Ballet Level*

If other, please specify

Please list any medical conditions or learning disabilities that teachers and staff should be made aware of:*

Please list any medications the applicant has on their person and a description of how they should be used:*

How did you hear about us?*

If other, please specify

Please read carefully

By submitting the application you acknowledge and agree to the following:

1. Refunds will only be available up until the week prior to the event for ligitimate reasons including illness and unforseen circumstances. The entire amount is refundable, less a $75 administration free;

2.All Repertoire Intensive submissions must be completed by COB on Friday December 13th, 2024 at 5:00pm;

3. Please make sure to consult the 'BTQ Levels Aligned with Ballet Syllabus' document on our website to make sure you correctly identify which level to select for your dancer. For any queries, please email, contact@btq.com.au

4. Please note that all dancers are placed in a level based on their current level of study and age. The artistic team will assess dancers individually on the first day of the Intensive to identify if a dancer should be placed in a different level. This is to ensure each dancer will have the best experience possible. Parents and Guardians will be contacted to discuss any possible changes;

5. Throughout the Intensive period BTQ will capture the event in the form of short video clips or in-action pictures. Your dancers may be featured in our social media footage, stills or audio content. If you do not wish to have your dancer on our social media, please email seperately to contact@btq.com.au

6. A showcase of the weeks repertoire will be presented on Saturday the 21st of December for family and friends of participants. The number of seats will be determined closer to the event and capped based on the number of participants.

7. Career Development Scholarships and Genre Awards will be presented during the Saturday presentation. These awards are decided by the panel of guest coaches and no descusion regarding the outcome will be entered into.

8. It is recommended that Character SHOES are the preferred footwear for the Flamenco classes (such as BLOCH Canvas Tempo Character Heel/Cuban Heel). Men to have leather shoes with a heel but not tap. For more information contact us via email at contact@btq.com.au

Application Fee*

Junior Apprentice/Junior Application Fee

$450.00AUD Quantity

Intermediate/Senior Application Fee

$650.00AUD Quantity

Total

$0.00AUD

Payment Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Repertoire Intensive - December 16-21, 2024

Dancer Information Below