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Dancer's Full Name*

Dancer's Age*

Dancer's Pronouns (optional)

Parent/ Guardian Full Name*

Parent/Guardian Email*

Parent/Guardian Phone Number*

Emergency Contact Name/ Number *

Home Studio/Training Facility*

Total Weekly Hours of Ballet

Total Weekly Hours of Technique

Tee Shirt Size*

Any injuries, medical conditions, or allergies we should be aware of? *This information will be kept confidential and used for safety purposes only.*

☐ I understand tuition is $800, with Early Bird pricing of $695 available through January 12, and that payment plans may be offered.

Instagram Handle

How did you hear about us?

PAYMENT OPTIONS*

Early Bird Deposit$200

Early Bird Tuition$695

Experience The Difference

Top Notch Quality Dance Training

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