New England Ballet
School & Company

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

Registration Form: 4 Week Session t June 2-June 26

To register: 1. Complete and Sign this form 2. Include Tuition. (non- refundable) Deadline for registration is May 24, 2008. Thank you!!

Student Personal Data:

Check one: New Student_____ Returning Student_____ Student of another School________

Name_______________________________________________________Date of Birth______________________

Address_____________________________________________________Age_____________________________

City / Zip____________________________________________________School Grade_____________________

Parent / Guardian_____________________________________________Home Tele._______________________

Business Address_____________________________________________Work Tele._______________________

 

 

Faculty: Karen Goodman, Linda Giancaspro, Chelsie Davis

 

 

Total Tuition

Classes ___________________________________ _________

________________________________ _________

Total $________

 

Total Tuition for Classes is due before May 24, 2008

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’s classes or activities.

 

Signature____________________________________________________Date________________

(Parents or Guardian if student is under 18 years)