| The Alexandria Ballet Registration Form 2010-2011 (Print this form and mail it in or bring it to class.) 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 ___________________________ ______________________________ ____________________ ___________________________ ______________________________ ____________________ ___________________________ ______________________________ ____________________ The registration fee is $100. Please make checks payable to Virginia Britton or The Alexandria Ballet. Payments are due by the 7th of the month. Please include a $15 late fee if paying after the 7th. Bring payment to class or mail to: 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 2010-2011, (rev 6) 5/19/2010 . Signature: Student _______________________________________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 2010-2011 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 Regan Dance Center 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 Regan Dance Center 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 for Ballet II and up. (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: Please be quiet and respectful in behavior to others in the studio. Parents and waiting siblings and friends are expected to be quiet as well. Pleas take cell phones outside. Snow: Please look at the snow closings of the Alexandria Public School System. We follow their snow day or ice hazard closing announcements. Photos and Video: Parents, guardians, and students grant The Alexandria Ballet use of any recorded images of themselves in ballet classes, rehearsals or performances. Holidays: See the online Calendar for the list of holidays when there is no class. (rev 7) 7/16/2010 |
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