Registration Form

Name *
Name
Date of birth
Date of birth
Phone *
Phone
Best way to contact you
Parent Name *
Parent Name
Address *
Address
Are you a returning student?
Previous Dance Experience?
If answered yes, please explain.
Please indicate if you are in Jr. Company here.
We would love to hear how you heard about us!
Please list any health condition that we need to be made aware of, ie. asthma, past injury, etc.
For sponsorship reasons only.
Classes
Monday Classes
These classes are available on Monday at Dominion Arts Center
Tuesday Classes
These are the classes available on Tuesday at The Glen Allen Cultural Arts Center.
Wednesday Classes
These classes are available on Wednesdays at Glen Allen Cultural Arts Center.
Thursday Classes
These classes are available on Thursdays at Dominion Arts Center.
Other Important Information
Emergency Contact *
Emergency Contact
Emergency Contact Information *
Emergency Contact Information
$
Missed Classes *
Missed classes may be made up with any equivalent class of your choice.
Photography and Videography Waiver *
I understand that by signing this agreement I give permission for any photos or videos taken of myself or my child, while engaged in activities at the Latin Ballet to be used in promotional materials.
Responsibility Waiver *
I am aware the all forms of dance and gymnastics associated with, place unusual stresses on the body and may carry with them the risk of injury. I understand that the Latin Ballet of Virginia or its staff, are not liable in any way for injuries sustained during attendance of the program or any of its functions.