New England Ballet
School & Company

200 Boston Post Road, Suite 8, Contempo Square, Orange CT 06477 (203) 799-7950 • www.newenglandballet.org

Registration Form: August 4-August 21, 2008

To register: (1.) Complete both sides of this form. (2.) Sign this form. (3) $200.00 Tuition Deposit (non- refundable). Please register early to insure that your class is open, class size is limited. Please register by June 26. Thank you!!

Student Personal Data:

Check one: New Student_____ Returning Student_________

Name_______________________________________________________Date of Birth______________________

Address_____________________________________________________Age_____________________________

City / Zip____________________________________________________School Grade_____________________

Parent / Guardian_____________________________________________Home Phone_______________________

Email________________________________________________________Work/Cell Phone___________________

Contact in case of an emergency___________________________________________________Phone___________________________

 

Classes you are registering for:

Please list Program/classes

______________________________________ Total Tuition  _________

______________________________________ _________

Deposit _________

 

Balance Due $________

 

Total Tuition for Summer Classes is due before August 4, 2008
Registration is for the full three weeks!

I agree to pay the entire tuition of the class(es) for which I have registered. I understand that refunds may be made only for prolonged illness or severe injury, verified by Physician's Certification.
I agree to hold New England Ballet School and its faculty and employees harmless for any injuries I may sustain as a result of my participation in New England Ballet School classes or activities.

 

Signature____________________________________________________Date________________
(Parents or Guardian if student is under 18 years)