County Ballet Student Registration
2232 Old Emmorton Road, Bel Air, MD 21015 - (410)-515-0031 or (410)-569-0316
Date of Birth: Present Age:
ADULT STUDENTS- Name and Phone # of Emergency Contact
How did you learn of County Ballet?
Which classes will you be taking?
Additional people allowed to pick up dancer? NAME, Relation to Dancer, Phone #
There is a $25.00 Registration fee per family /per year.
Liability Agreement: I agree that I will not hold a faculty member or an employee
of County Ballet, liable for injuries sustained or for illnesses contracted by me/my child
while a student/participant at County Ballet. I agree to indemnify County Ballet and its faculty
for all liabilities, costs, and judgments arising for acts of omissions of the undersigned,
which result in injury or damage to any person or party. I further agree that I will not hold
County Ballet or any faculty member responsible for the loss or damage
of personal property during participation.
TUITION MUST BE PAID IN FULL AT TIME OF REGISTRATION.
Checks, Cash and Credit Cards accepted. There are no transfers, credits, or cash refunds for classes unless medical certification is presented.
Uniform Agreement: All students should have the required uniform within two weeks of starting classes and maintain a proper uniform throughout the semester.
I have read and understand the refund policy, uniform agreement and waive all claims of liability.
Dancers image may appear in group photos or ads (no tagging)- YES or NO?
If you agree, please initial here:
I will phone in with credit card, mail in a check, or stop in and visit The Dance Shop. (Pick one)