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| Student |
| First Name: | |
| Middle Initial: | |
| Last Name: | |
| Birthday: | |
| Parent/Guardian |
| | Same as above. |
| First Name: | |
| Last Name: | |
| Home Phone: | |
| Mobile Phone: | |
| Work Phone (optional): | |
| Address: | |
| City: | |
| Zip Code: | |
| Email Address: | |
| Person Responsible for Payment: | |
| Emergency Contact |
| First Name: | |
| Last Name: | |
| Phone Number: | |
| How did you hear about us: | |
| Which Program are you interested in? |
| | Professional Program (ages 8 and up) |
| | Le Petit Ballet Pre-professional Program |
| What class(es) are you registering for?: | |
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There is a $25.00 ($15 for returning students) non-refundable registration fee. Students are not considered registered until the registration fee is received. Make checks payable to; Vero Classical Ballet.
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