Summer Registration

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*

Prior Years of Dance Instruction

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

Yes
No

If allergy or medical condition, please describe.

I am registering for:

Child Classes
Adult Classes

CHILD CLASS SELECTION

Child Class

Thrilling Thursdays: $320
RAD Pre-Primary & Primary: $455
Plié: $1625
Chassé: $1940
Passé, Changement: $2255

ADULT CLASS SELECTION
If you make a mistake, to reset form, click child
classes above, then adult classes once more,
and the selections will be cleared.

Adult Tuesdays

Tuesdays (6): $365

Adult Thursdays

Thursdays (6): $365

Silver Swans

Silver Swans (6): $320

Swans

Swans (6): $365

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 »

Total

$0.00

READY TO GET STARTED?