Duet- SRB Registration Form 2025-26
Please fill out the form and send us back.
Student's Name
*
First Name
Last Name
Birthdate
*
-
Month
-
Day
Year
Date
Student's Name (sibling #2)
First Name
Last Name
Birthdate
-
Month
-
Day
Year
Date
Parent's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Classes interested in
*
Pre-Ballet (age 4 - 5)
Ballet Beginning (ages 6 - 7)
Ballet / Pointe
Contemporary
Saturday Ballet/Pointe/Partnering/Work-out
Classes Attendance
*
Monday (Pre-Ballet)
Tuesday (Ballet Beginning)
Tuesday (Ballet/Pointe)
Wednesday (Ballet/ Pointe)
Thursday (Ballet Beginning)
Friday (Ballet/Pointe)
Saturday (Ballet/Pointe/Partnering/Work out)
Which program are you signing up
*
Full Year Intensive Ballet
Daily Open Classes
Are interested to take private classes
*
Yes
No
Please list any allergies or medical conditions your child has that we need to be aware of
*
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