Registration

Student Registration Form

Fill out the form carefully for registration
Student Name*

First NameLast nameCurrent Address
Birth Date*

MonthDayYear
Gender*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address *
example@example.com
Do you take any medication or have any allergies/medical condition that we should be aware of? if yes, please explain.
If you are pregnant and/or have any chronic injures, please seek advice of a doctor as well as a written note from them granting you permission to exercise and engage in ballet classes
Which class are you registering for?*
VERY IMPORTANT!!! If the student is a minor (below 18yrs), the guardian is required to fill out this section

All fields are required if the student is a minor
Guardian

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Does your child/children take any medications, or have any allergies/medical conditions we should be aware of? if yes, please explain.
This is to keep us informed in case of emergencies during classes.
Additional Emergency Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
How did you hear about Leotard ballet?
Please verify that you are human*
Should be Empty:

Student Registration Form