Child's Registration Form

Student Registration Form
(printable registration form here)

* Student/Participant Name (first, last)

Birthday Sex Age

What class or classes do you wish to sign up for?

Some classes may be full and no spots will be held for any class until payment is made in full.

Parent or Guardian

Home phone

Business phone

Cell phone

Home Address

City

State

Zip Code

* Home Email Address

Does the participant have any allergies or medical conditions of which we should be aware? If Yes, please describe:

Waiver of injury - Please Read

Waiver of injury: I, the undersigned, do hereby voluntarily submit my child and/or myself for attendance and participation in the Etudes de Ballet & Co. dance and other programs and do hereby assume full responsibility for any and all damages, injuries or losses that she/he/I may sustain or incur in anyway while attending or participating in any Etudes de Ballet & Co. classes or activities both in and away from the studio. I, the undersigned, do hereby waive all claims against the instructors, owners and/or operators, individually or otherwise, of Etudes de Ballet & Co. or J.D. Burt Company, Inc., for any injuries she/he/I may sustain while attending or participating in said programs, I fully understand that any medical treatment given to my child or myself will be for first aid only, but I give emergency treatment authorization if I cannot be reached. This form can be photocopied for emergency treatment. Additionally, I have read and understand the Etudes de Ballet code of conduct, general regulations and tuition format outlined on below.

I agree with the above injury waiver. Yes No

Etudes de Ballet & Co. Code of conduct and regulations: Please Read

(1) I understand and acknowledge that Etudes de Ballet & Co. has a strict policy of NO REFUNDS for any reason, including but not limited to: bad grades, a loss of interest, injury, moving out-of-town, and transportation problems. (2) Dress Code adherence for ballet, including hair tied securely back in bun, is expected (except the last week of the session when the dress code is waived.) Level I - VII ballet students are expected to wear black leotards, pink tights, pink ballet slippers and no jewelry. Preballet (age 3 - 6) will be expected to wear the required pink tunic for their class (in most cases age group), white socks with pink ballet slippers. (3) Students must be on time (unless there are traffic problems beyond the student's control) or they will not be allowed to take that class. (4) Students must wait in lobby until class is called. (5) Students will not be permitted to leave (i.e. disrupt) class early without prior approval. (6) No smoking allowed inside any part of the facility. (7) No food or drink is allowed inside any studio. (8) All Jazz Team participants are required to attend a minimum of 1 ballet class per week at Etudes de Ballet & Co. (9) Children not attending classes are expected to be supervised at all times. (10) Screaming/whining children are to be taken outside the building to make it more pleasant for the people inside. (11) Missed classes must be made up in the present term. (12) No spots will be held in classes until full payment is received. (13) All children must be potty trained to begin classes.

I understand and acknowledge that Etudes de Ballet & Co. has a strict policy of no refunds for any reason AND I hereby agree to enroll my child accepting these terms. I have read and agree with the above understanding the code of conduct and regulations.
Yes No