| The Alexandria Ballet Registration Form 2011-2012 Students name:______________________________ Date of Birth:__________________________ Parent's names (if student is under 18):______________________________________________________ Address:______________________________________________________________________________ City, State, ____________________________________________Zip_____________________________ Phone #s(home)______________________(work)___________________(cell)_____________________ Previous years of training:________________________________________________________________ Emergency contact:______________________________Email:__________________________________ Please list any Allergies, ailments, or special medical conditions, past or present, of which The Alexandria Ballet should be aware _________________________________________________________ _____________________________________________________________________________________ Class Time / day Monthly tuition ___________________________ ______________________________ ____________________ ___________________________ ______________________________ ____________________ ___________________________ ______________________________ ____________________ Please make checks payable to Virginia Britton or The Alexandria Ballet. There is no registration fee for summer classes in 2011. Tuition payments are due on the first class of the month. Fall - Spring registration fee is $90, to hold a place in the class. Virginia Britton 3421 Valley Drive Alexandria, VA 22302 I have read, understand and agree to abide by The Alexandria Ballet - Conditions for Enrollment, Liability Release and Medical Release 2011-2012. Dated 5/25/11. Signature: _______________________________________Date__________________ (or parent or legal guardian if under 18) (For office use: check #_________________ amount _____________ date _______________ ) The Alexandria Ballet - Conditions for Enrollment, Liability Release and Medical Release 2011-2012 Virginia Britton, Director 703-379-8997 or 703-568-4425 Liability Release: I am aware that dance training and the athletic exercises associated with it place unusual stress on the body and carry the risk of physical injury. On behalf of my child and myself (and if I am no longer a minor, on my own behalf), I assume the risk and agree that The Alexandria Ballet and Forever Dancing shall not be liable in any way for injuries sustained during attendance at the ballet school or any of its' related functions. I understand that good ballet training involves touching and adjustment of the student's body by the instructor. Medical Release: In the event I cannot be reached, I hereby give my permission to the management, faculty staff and chaperons of The Alexandria Ballet or Forever Dancing to authorize any emergency medical care that may be required by my child or ward during participation in classes, performances or any related Alexandria Ballet events. This authorization extends as long as the student is enrolled at The Alexandria Ballet. I understand that I am responsible for any and all charges as a result of such care or medical treatment. Make up classes: Students in some classes can make up lessons in other groups and are encouraged to do so, call the 703-568-4425 home office of Virginia Britton to get recommendations. Regular training is essential for progress in classical ballet as in all physical endeavors, and students who miss too many lessons, in the opinion of the Director, may be asked to move to the next level down. Dress Code for students under 18 years: Girls- Plain black leotard, no decorations, Pink ballet tights, Pink ballet slippers, elastic sewn on over high instep, drawstrings trimmed and tucked under. Hair up with no moving pieces, avoid decorated accessories. No underwear except ballet bra for older girls. Small stud earrings are OK otherwise no jewelry or watches. Water bottles are encouraged. (Optional) Black ballet sweater, pale pink leg warmers. Boys- Plain black close fitting dance pants, heavy weight cotton blend recommended. White tee shirt, short or long sleeves, tucked in. White socks, white ballet slippers with elastic sewn on in cross over high instep or across top of instep, no jewelry or watches. Black leg warmers, white long sleeve turtleneck shirt for cold weather. Lateness- students who miss the first warm-ups may be asked to watch class or make up class at a later date, as the warm up exercises are critical for safety. Payment of tuition entitles the student to take the class scheduled at their level and at the times listed on their registration form. No refunds will be given for classes missed by students due to illness, vacation, or school closings due to acts of God such as inclement weather, etc.. Discipline: Students who are repeatedly disruptive in class, in the opinion of the instructor, will be asked to leave the school. A pro rated refund will be given to the student and they will not be allowed to return for the rest of that year. Cancellations: Classes may be cancelled at the discretion of Virginia Britton, due to insufficient enrollment, or other conditions she deems beyond her control . All registered students will receive prorated refunds for cancelled sessions. Manners: Quiet and respectful in behavior toward others is expected in the studio. Parents and waiting siblings and friends are expected to be quiet as well. Please take cell phones outside. Parents may read quietly to siblings in the waiting area. Snow: Please look at the snow closings of the Alexandria Public School System. We follow their snow day or ice hazard closing announcements. Observing Class: Children are easily distracted, so we encourage parents to occasionally peek in at students in a way that they will not be observed. Photos and Video: Parents, guardians, and students grant The Alexandria Ballet use of any recorded images of themselves in ballet classes, rehearsals or performances. rev 5/25/11 |
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