MN Dance Camp/Pre-Ballet Workshop Registration Form

St Paul: 314 Chester St, St Paul, MN 55107

Woodbury: 7582 Currell Blvd, Woodbury, MN 55125

REGISTRATION Form

Minnesota Dance Camp/Pre-Ballet Workshop

2016

*Before registering, get more information about classes here*

Please register as a user for this site or log in to view this form.

Problems logging in or accessing the form? Please email llparker100 at gmail.com

CBA Student Registration Form: Dance Camp/Pre-Ballet Workshop

Student Information

First name *

Last name *

Student Date of Birth *

Student Age *

Street Address *

City *

State *

Zip code *

Summer Program

Program Choice *

Minnesota Dance Camp

Pre-Ballet Workshop

Minnesota Dance Camp

June 27-July 15 2016

Minnesota Dance Camp Level (All at St. Paul studio)

Beginning/Intermediate

Intermediate/Advanced

Number of Weeks Attending

Two weeks

Three weeks

Attendance

Week 1

Week 2

Week 3

Minimum of two weeks required

Pre-Ballet Workshop

June 6-July 7 2016

Location

Woodbury, Tuesdays 5:30-6:30 pm

St. Paul, Mondays 5:30-6:30 pm

*Parent/Guardian Information

1) Parent/Guardian Name *

Cellphone Number *

Email Address *

Workplace (this helps Ballet Minnesota with funding requests)

2) Parent/Guardian Name

Cellphone Number

Email Address

Workplace (this helps Ballet Minnesota with funding requests)

Other Information

Academic School

Phone Number

Local Newspaper

Agreement to expectations and terms

Financial:
Registration/Tuition Fee are due in full at registration. A student is not considered registered until a payment for the full costs are received at CBA. Payments should be made immediately within the first week of online registration.

Other:

1. Please inform staff of any medical conditions which might affect class participation.

2. The parent or guardian agree that in case of medical emergency, after every reasonable effort has been made to contact them, to have the physician secured by the adult in charge of activities to hospitalize, secure treatment for and to order injection, anesthesia or surgery for the child. In the event any such treatment is not covered by insurance applicable to the activities, the parent / guardian will pay the expenses incurred in such emergency treatment.

3. Classical Ballet Academy, employees and/or guests shall not be held responsible for injury or illness to a student while student is attending classes or performing with CBA or Ballet Minnesota.

4. Any photos taken by CBA or Ballet Minnesota of a CBA student, while enrolled in CBA (during class, rehearsal or performance), may be used by CBA or Ballet Minnesota for advertising, promotion, and/or publication purposes.

Signature *

Clear

Parent / Guardian: I acknowledge that I have read the above rules and by signing here I agree to the conditions of these CBA rules & regulations as stated above. ( Form must be signed in order to be registered at CBA)

Payment Information

Payment Method *

Check

Credit Card (subject to 5% convenience fee)

PLEASE NOTE: Currently, credit card payments must be made in person at the CBA front desk. Fully integrated online payments are coming soon (fall 2016).

Please print out your confirmation email and/or make note of your total amount due, which includes 5% convenience fee.

If you have multiple children enrolled, please calculate and apply the following discount:

Two children - 4%
Three children - 6%

Please make checks out to Classical Ballet Academy of Minnesota, and mail to or drop off at the St. Paul Lowertown studio:
249 East Fourth Street, St Paul, MN 55101

If you have multiple children enrolled, please calculate and apply the following discount:

Two children - 4%
Three children - 6%