Location:        St Paul (    )      Woodbury (    )   
Student level:    Levels:  1(   ), 2A(   ), 2B(   ), 3(   ), 4(   ), 5(   ), 6(   ), 7(   ), 8(   )
   < Pre-Ballet Woodbury. Tuesday (   ), Thursday (   ) >    Pre-Ballet St Paul (   )  

Student Name: (Last)_______________________   (First)__________________

   Birthdate: ____/____/____     Age:_____

   Address: ________________________________________________
   City: ____________________   State: _________    Zip: _______________
   
   E-mail:  ____________________________________
   Home Phone: _(____)_________________

Mother/Guradian:_________________________________________________
         Cell (H):_(____)_____________
         Phone (W):_(____)_____________        Work:________________________  

Father/Guradian:_________________________________________________  
         Cell (H):_(____)_____________
         Phone (W):_(____)_____________        Work:________________________      

Academic School: __________________________  (phone): _____________

Local Newspaper: ______________________________________________ 

How did you find out about CBA:
               (     ) Friend          (     ) Poster          (      ) Performance(      ) Ad    
         (   ) Internet         (      ) Flyer           (     ) Yellow Pages          (     ) Mail
                                        Other:_______________________

Make sure to include the following with registration:

- one time yearly registration fee: $50.00
- one time CBA organizational support: $50.00 (volunteers: $25 credited back to tuition)
- full tuition (level 2 and up may pay in 3 payments the 1st Sturday of each month)

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Parent/Guardian: Your signature below indicates approval and permission of the following:

Financial:
     1.  Registraion, Tuition & Support Fee is due in full at registration. Monthly payments are available for level 2 and up. Tuition is based on a yearly program from September thru May. The tuition is broken down in cost per session. However, students in level 1 and up sign up for the year.
    2.  CBA depends on volunteers. To that end there is a CBA organizational support fee of $50.00 for the year. If a parent volunteers 4 or more hours of help for a production, $25.00 will be credited back toward tuition. Fee will be paid at registration.
     3.  A $50.00 non-refundable annual registration fee is required to hold a place in class. Fee will be paid at registration
     4.  Level 4 & Up: By signing this registration form you commit to a yearly contract with CBA.
     5. Monthly & full session installments are due the first Saturday of each month and must be paid before a student attends class.
     6.  If a child registers for classes and then takes only one or a few classes during either Fall, Winter or Spring session, the full tuition for the session will be charged. There will be no refunds.
     7.  Refunds only for classes canceled by CBA.

Medical:
     1. Please inform staff of any medical conditions which might affect class participation.
          _______________________________________________________________
     2 The parent or guardian agree that in case of medical emergency, after every reasonable effort has been made to contact them, to have the physician secured by the adult in charge of activities to hospitalize, secure treatment for and to order injection, anesthesia or surgery for the child. In the event any such treatment is not covered by insurance applicable to the activities, the parent / guradian will pay the expenses incurred in such emergency treatment.

Other Considerations:
     1.  Classical Ballet Academy, employees or guests shall not be held responsible for injury or illness to a student while student is attending classes or performing with CBA or Ballet Minnesota
      2.  A student must be registered as a CBA student at the time of a dance production in order to perform in that production.
      3. Any photos taken by CBA or Ballet Minnesota of a CBA student, while enrolled in CBA (during class, rehearsal or performance), may be used by CBA or Ballet Minnesota for advertizing, promotion, publication purposes.
      4.  A student's advancement, performance and roles are solely at the discretion of the directors.
      5. If a student is late for class, teacher permission is required for child to enter class.

Parent / Guardian:    I acknowledge that I have read the above rules and by signing below I agree to the conditions of these CBA rules & regulations as stated above.
        (parent / guardian must sign this form in order to have a child registered at CBA)

Signature:_______________________      Date:_____________

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