Alabama Ballet School Registration Student Registration Please enable JavaScript in your browser to complete this form.Name of Student *FirstLastParent Name *FirstLastParent Email *For main contact, e-newsletter, etc.Secondary Email (optional)Parent Phone # *Best # to reach you during classStudent's Primary Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDate of Birth (MM/DD/YY) *GenderFemaleMalePrefer not to specifyClass Applying For *Pre-Ballet/Tap (3-4 years old) - MondayDance to Your Own Tune (4 years old) - WednesdayDance to Your Own Tune (4 years old) - SaturdayPre-Primary (5 years old) - TuesdayPre-Primary (5 years old) - WednesdayPre-Primary (5 years old) - SaturdayTap I (4-6 years old) - MondayPrimary (6 years old) - TuesdayPrimary (6 years old) - ThursdayRAD Level I (7 years old) - MondayRAD Level I (7 years old) - ThursdayTap II (7-8 years old) - MondayRAD Level II (8 years old)RAD Level III (9 years old)RAD Level IV (10 years old)RAD Level V (11 years old)RAD Intermediate FoundationRAD IntermediateRAD Advanced FoundationRAD Advanced Performance Course - by audition onlyAll age recommendations are approximate. The faculty will evaluate students and adjust class placement as appropriate. As classes meet capacity, they will be noted as full. You may register for a full class to be added to the waitlist.How would you like to pay tuition? *in 8 installmentsby semesterby yearIf registering multiple students in a family, please list the additional student's full name, DOB and class applying for as well as any information that differs from the primary registrant.Academic School/School Phone # *If parents have separate addresses, please list secondary address.Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeFamily Physician *Phone # *Any known allergies, medical conditions or medications being takenso that we can better take care of our students in case of an emergencyPrevious dance training (school, teacher, subject, years training, number of classes/week) *Parent/Guardian Authorization: Please e-sign below by including Parent/Guardian Name, Date, Child's Name. *I AM AWARE THAT DANCING, AND THE EXERCISES ASSOCIATED WITH IT, PLACE UNUSUAL STRESSES ON THE BODY, AND CARRY WITH THEM 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 ALABAMA BALLET SHALL NOT BE LIABLE IN ANY WAY FOR INJURIES SUSTAINED DURING ATTENDANCE AT THE ALABAMA BALLET SCHOOL OR ANY OF ITS RELATED FUNCTIONS. I GRANT MY CHILD, OR WARD, PERMISSION TO PARTICIPATE IN THE ALABAMA BALLET SCHOOL SESSION. I HEREBY RELEASE AND DISCHARGE THE ALABAMA BALLET, ALABAMA BALLET SCHOOL, ITS AGENTS, EMPLOYEES, AND OFFICERS FROM ALL CLAIMS, DEMANDS, ACTIONS, JUDGEMENTS AND EXECUTIONS WHICH THE UNDERSIGNED’S HEIRS, EXECUTORS, ADMINISTRATORS OR ASSIGNS MAY HAVE, OR CLAIM TO HAVE AGAINST THE ALABAMA BALLET, ITS SUCCESSORS, OR ASSIGNS, FOR ALL PERSONAL INJURIES CAUSED BY, OR ARISING FROM, THE ABOVE DESCRIBED ACTIVITIES, OR ANY ACTIVITIES RELATED THERETO. FURTHER, I GRANT ALABAMA BALLET, THE ALABAMA BALLET SCHOOL, ITS AGENTS AND EMPLOYEES, PERMISSION TO AUTHORIZE ANY EMERGENCY MEDICAL TREATMENT THAT MAY BE REQUIRED FOR MY CHILD, OR WARD, DURING THE SCHOOL SESSION.Medical Insurance Provider *Policy Number *Coverage Dates *Student e-signature and date *AS A REPRESENTATIVE OF THE ALABAMA BALLET SCHOOL, I AGREE TO ABIDE BY THE RULES AND REGULATIONS OF THE ALABAMA BALLET SCHOOL.Student e-siganture and date (Parent/Guardian signature if student is a minor) *I, THE UNDERSIGNED, HAVE READ THIS RELEASE/AUTHORIZATION AND UNDERSTAND ALL OF ITS TERMS. I EXECUTE IT VOLUNTARILY AND WITH THE FULL KNOWLEDGE OF ITS SIGNIFICANCE.Student e-siganture and date (Parent/Guardian signature if student is a minor) *I HEREBY GIVE PERMISSION FOR THE ALABAMA BALLET AND/OR ALABAMA BALLET SCHOOL TO USE PHOTOGRAPHS/VIDEOS OF MY LIKENESS IN ALABAMA BALLET AND/OR ALABAMA BALLET SCHOOL SPONSORED PUBLICATIONS AND FOR PROMOTIONAL PURPOSES.Student e-signature and date (Parent/Guardian signature if student is a minor) *I, THE UNDERSIGNED, HAVE READ AND AGREE TO FOLLOW THE ALABAMA BALLET SCHOOL HEALTH & SAFETY GUIDELINES (https://alabamaballet.org/wp-content/uploads/2022/04/School-Health-and-Safety-Guidelines-updated-April-22.pdf) I UNDERSTAND THAT THESE GUIDELINES ARE SUBJECT TO CHANGE. We ask that each student submit a ‘Blue Form’ from your pediatrician’s office before the start of classes. You may email to nataliecambron@alabamaballet.org or mail/deliver to our office at 2726 1st Ave S, Birmingham, AL, 35233. *I understand and will provide a Blue Form from our pediatrician.Student Registration Fee *Price: $ 30.00One-time fee per familyCredit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2223242526272829303132NameSubmit Address 2726 1st Ave S. Birmingham, AL 35233 205-322-4300 information@alabamaballet.org HELPFUL LINKS Donate Upcoming Performances Alabama Ballet is a 501(c)(3) nonprofit organization Follow FollowFollowFollowFollow Press Inquiries: chloebowen@alabamaballet.org NEVER MISS A BEAT Success! Email Subscribe
