BYB-Summer Enrollment

ENROLLMENT FORM

SUMMER 2008
ENROLLMENT FORM

SUMMER 2008 ENROLLMENT FORM

Please complete the following form and simply click the "Submit" button once. Administrative staff will contact you shortly.

Or, you can download the following Enrollment Form in PDF format or Enrollment Form in Word format, fill in the information and send it back to us. Our address is 1595 Mercer Rd., Suite 150, Lexington, KY 40511.

If you have any questions about enrolling in BYB, please call 859-271-4472. Our staff can assist you. Thank you.

* indicated required field, which information must be provided in order to submit the enrollment form successfully. If any of the required field is not applicable, please enter n/a and proceed to the next question.

I would like to enroll for: *
Session 1 Classes June 9-28
Please specify which class
Session 2 Classes July 7-26
Please specify which class

Summer Intensive Workshop (June 9-27) (Evaluation required prior to enrolling)
June 9-13 June 16-20 June 23-27

Young Dancer Workshop Session 1 (June 16-26)
June 16, 17, 19 June 23, 24, 26
Young Dancer Workshop Session 2 (July 21-25)
July 21-25

Kids Fun Arts Workshop
July 21-25

1. Student's Name: *

2. Age: 3. Date of Birth: 4. School Grade:

5. Home Address: *

6. City: * 7. State: * 8. Zip Code: *

9. School Attending:

10. Home Phone: * 11. Cell Phone: *

12. Parent's or Student's Email: *
(Your Email address will be used for BYB communicative purpose only.
Please submit your current Email address.)

13. Mother's Name:

14. Father's Name:

15. Emergency Contact Number:

16. Training:
*

17. Medical Conditions:
*

18. How did you hear about BYB?:
*

Waiver of Liability:
I, the undersigned unconditionally release and discharge Bluegrass Youth Ballet, inc. and its faculty and staff, employees, directors and volunteers from any and all liability arising from, related to, or connected with any injury, illness or damage caused by, resulting from, or sustained in the course of my participation in classes, performances or other activities conducted by or associated with Bluegrass Youth Ballet, inc. I hereby attest that this Waiver of Liability is provided voluntarily and shall by fully binding upon my heirs, next-of-kin, executor, administrator and/or personal representative.*

I HAVE READ AND UNDERSTOOD THE BLUEGRASS YOUTH BALLET RULES AND POLICIES

Student attending BYB Summer Intensive for first time must attach a small resume, a letter of recommendation and a photo in first arabesque with this application.