Student Registration Form

Student Registration Form
Passion, artistry, heartfelt worship, and technical excellence define Ballet
Magnificat!’s Company. Ballet Magnificat! began over thirty years ago with Kathy’s
vision to reach the nations with the gospel of Jesus Christ through original and
powerful repertoire. The Company Artists command the stages of theaters, opera
houses, concert halls, performing arts centers, church auditoriums, and civic arenas
with sublime beauty and unparalleled artistry. Ballet Magnificat! has become a
vigorous force, telling the tale of God’s love, reaching deeply into the hearts of the
audience, and inspiring genuine conviction in those who watch.
Graceful Gifts is proud to offer our very first Ballet Magnificat! In-house workshop on Saturday, April 18th at 597 Haverty Ct. Unit 80 Rockledge!

This workshop will look as follows:
1:30 - 3:00 pm
Beginner Ballet Technique
Intermediate Ballet Technique
Advanced Ballet Technique
3:10 - 4:25 pm
Beginner Contemporary
Intermediate Contemporary
Advanced Contemporary
4:35 – 5:50 pm
Beginner Jazz
Intermediate Jazz
Advanced Jazz
6:00 - 7:00 pm All Levels Creative Worship
Participant prices are as follows: $65/dancer

Please complete and return to the studio hosting
the Ballet Magnificat! workshop.
Dancers' First and Last Name:*
Address:*
City/State/Zip:*
Contact Phone #:*
Contact Email:*
example@example.com
Dancers' Date of Birth:*

MonthDayYear
Date
Age:*
Dance Training (ballet, jazz, etc & # of years):*
Years of Ballet Since Age 8:*
Years on Pointe (if applicable):
How did you hear about the Ballet Magnificat! workshop?
Emergency Contact Name:*
Mobile Phone #:*
Relationship to Applicant:*
SERIOUS MEDICAL CONDITIONS
If you have a serious medical condition that the teachers of this workshop need to be aware of, please use the following space to outline your condition.
I carry an EpiPen.
LIABILITY RELEASE
I/We hereby release Ballet Magnificat! and host studio/sponsor, their agents, employees, and volunteer assistants, from any liability whatsoever arising out of any injury, damage, or loss which may be sustained by the above-named applicant during the workshop.
Participant Signature

Clear
Signature of Parent/Guardian (if applicant is under 18)

Clear
Date:

MonthDayYear
Date
Date:

MonthDayYear
Date
PHOTO RELEASE
I grant to Ballet Magnificat!, its employees, agents, and assignees, the right and permission to make, reuse, and/or publish photographic pictures or video tapings of me, which may be used in connection with my own or a fictitious name, for any purpose whatsoever including the use of any printed matter. I waive any right to inspect or approve either the finished photograph or video or the printed matter or video with which it may be used in conjunction.
Participant Signature

Clear
Signature of Parent/Guardian (if applicant is under 18)

Clear
Date:

MonthDayYear
Date
Date:

MonthDayYear
Date
For information about Ballet Magnificat!'s Summer Dance Intensive visit www.balletmagnificat.com
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Student Registration Form

SERIOUS MEDICAL CONDITIONS

LIABILITY RELEASE

PHOTO RELEASE