2010-2011 Registration Form
Please fill out a separate form for each student.

If you would like to print out this form and mail to the Greenville Ballet - click here.

*Required Fields.

*Parent's Email Address
*Student’s Name
*Address
*City
*State
*Zip
*Home Phone	- -
Cell Phone
Student’s Email Address
*Grade (10-11)
*Birth Date (not 2010)	/ /
Academic school student attends
*Mother/Guardians' name
Father/Guardians' name
Physician’s Name
Physician's Phone #
Father’s employer
Father's Work #
Mother’s employer
Mother's Work #
*How did you hear about us: check one or more:
Television ad	Radio ad
Yellow pages	Web Site
Word of Mouth	Mailing
*REGISTERING FOR (check one or more):
Pre-Ballet (age 4-5)	Elementary Ballet (grades 1-3)
Intermediate I	Intermediate II
Intermediate III	Pointe
Advanced Ballet	Modern
Nutcracker	Teen
Adult Ballet	Tap
Variations	Boy's Class
Jazz	Hip-Hop
Competition	Spring Performance
Please specify preferred class day (1st and 2nd choice)
Submitting this form means that you accept the following: "I hereby enroll myself or my child for the entire term and agree to follow all payment policies, dress code, and other rules and regulations as stated in this web site. I understand that tuition payments are due on the first of the month September thru May and that all tuition payments are nonrefundable and agree to pay the late fees for late tuition payments and the service charge for bad checks. I recognize that attendance and participation may expose me or my child to risk of injury and harm. I accept this risk and agree that Greenville Ballet School and its staff will not be held responsible should such injury or harm occur. I hereby authorize the Greenville Ballet School to use photographs of the student on its website and in any publicity materials. "

 

2010 SUMMER Registration Form
Please fill out a separate form for each student.

Online registration.

Print and mail in form.

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