Academy of Ballet in Fredericksburg VA, Come Dance With Us!

REGISTRATION

Registration Form
Student's Name:
DOB:
Parent or Guardian:
Address:
Phone#
Home:
Work:
Cell:
In case of Emergency Notify:
Phone:
Email Address:
Physician:
Physical Restriction or Disability:
Previous Dance Instruction:
I have read the policy sheet for the Academy of Ballet and I understand my obligation to the school.
Signature:
Date:
Classes:
Tution is payable in advance on the first of each month. There is a registration fee of $15.00. statements are sent only if your account is delinquent. A late charge of $10.00 will be assessed all payments received after the 10th. It is the policy of the school that missed classes (due to illness) may be made up within a month in any class that is not part of the student's current schedule. Arrangements should be made with the student's instructor. Refunds for tution can not be made. The Academy of Ballet cannot assume responsibility for personal belongings or injuries incurred while on the premises or in any school function. Children (not in class) must be accompanied by a parent or guardian while at the Academy.

Photo/Video Release Form
Date:
Program:
Description:
I give permission for my child/myself (print name) to be photographed and for videotaped. I am aware that the photograph, image or videotape may be used in publicizing the above mentioned program in print or electronic media and or The Acadamy of Ballet website. I acknowledge and agree that my participation in photographs and videos may be edited and used in whole or in part as desired for this program, which may be produced duplicated, distributed and used for informational purposes. I understand that photographs become the property of The Academy of Ballet without compensation.
Signed (Signature of parent or legal guardian if person in program is under 18 years of age)
Print Name:

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