On-Line Registration Form
Please fill out this form and you will receive an conformation Email.
The Academy of Ballet will contact you with Tuition totals and to answer and questions.
* = required feilds
*Parent/Guardian   
*Address 1   
Address 2   
*City   
*State   
*Zip Code   
*Email Address   
*Phone Number   Home   Cell
*Emergency Contact Name Phone

Student 1 Name: Age: Date of Birth (mm/dd/yyyy):
Class(es) attending:    reg fee $25.00 + tuition:

Student 2 Name: Age: Date of Birth (mm/dd/yyyy):
Class(es) attending:    reg fee $5.00 + tuition:

Student 3 Name: Age: Date of Birth (mm/dd/yyyy):
Class(es) attending:    reg fee $0.00 + tuition:

More Information or Questions:

* I have read the tuition schedule and accept my responsibility for payment.  I understand that my child will be participating in an active program and accept the risks involved.

*