Dance to Your Own Tune for 2 & 3 Year Olds - MONMOUTH ACADEMY OF BALLET

STUDENT INFORMATION

Are you/your child a:

New Student
Returning Student

Student Name*

First Last

Date of Birth*

Age*

Address*

Street Address Address Line 2 City State ZIP Code

Parent Name*

First Last

Phone*

(REQUIRED)

Email*

(REQUIRED)

Any allergies or a medical condition we should be aware of?*

Yes
No

If allergy or medical condition, please describe.

Additional Information or Questions

Dance To Your Own Tune Class Time*

Group A - 9:30AM - 10:15AM
Group B - 10:30AM - 11:15AM

Preferred Payment Method*

We require that you provide a credit card that we store securely in our system regardless of payment method preference.

Credit Card
Cash or Check

Credit Card Information*

We require that you provide a credit card that we store securely in our system regardless of payment method preference.

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

*We add a 3% convenience fee to all invoices that are paid via credit card.

Payment Terms*

I agree to the payment terms

I understand all fees must be paid when due, and there will be no refunds for any portion of tuition and fees paid. If paying by credit card, you hereby authorize Monmouth Academy of Ballet to charge your card when payments are due. If you elect to pay by cash or check, and your payment is more than 10 days past due, you hereby authorize Monmouth Academy of Ballet to charge your card for the amount due, plus a $50 fee. If your check is returned for any reason, you hereby authorize Monmouth Academy of Ballet to charge your card for the amount due, plus a $50 fee.

Policies, Calendar and Schedule*

I Agree to Policies, Calendar and Schedule

I have read and agree with the Monmouth Academy of Ballet’s POLICIES & PRACTICES, CALENDAR and CLASS SCHEDULE posted on its website.

Consent for Photography and Video

I give permission.

I hereby give permission to Monmouth Academy of Ballet to use for publicity purposes still photos and
videos of my student taken during class and performances.

Release of Liability
Prior to the student's first class, every student (or legal parent or guardian) must agree to and sign the Monmouth Academy of Ballet's Release of Liability - to be provided and executed in-person. This form was included in your welcome packet, and is also available here »

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Monmouth Academy of Ballet | Dance to Your Own Tune for 2 & 3 Year Olds

A Creative Movement Class for Ages 2–3 with Parent or Care-Giver

What to Wear

Registration

Check out our class schedule here!

READY TO GET STARTED?