SUMMER BALLET Classes & Intensives REGISTRATION FORM · SUMMER BALLET Classes & Intensives REGISTRATION FORM 328 East 61st Street, Second Floor, New York, NY 10065 917-281-1030 Studio

SUMMER BALLET Classes & Intensives

REGISTRATION FORM

328 East 61st Street, Second Floor, New York, NY 10065

917-281-1030 Studio / 917-281-1032 Fax / 212-204-6348 www.theballetclub.com [email protected]

CHECK Class type:

PRIVATE INTENSIVE, AGES 7-18 yrs TBD

PRIVATE LESSONS, AGES 7-18 yrs TBD

CHILDREN’S CLASS, AGES 2 - 8 yrs TBD

ONLINE CHILDREN’S BALLET CLASSES FIRST TERM: JUNE 13 - JULY 18

PRIVATE INTENSIVE: $1,000 per week; $275 per day PRIVATE LESSON: $150 per hour CHILDREN’S CLASS: $50 per class; $ $350 per group of 8 classes; $425=10 classes **Discount available for siblings

ONLINE BALLET CLASSES:

$125 FOR FIVE WEEK SUMMER SESSION

_____Credit Card (MC, Visa, Amex): Name on Card: ________________________________

Amount: $ __________ Card #: ________________________________Exp. Date: _________

CV#: __________ Signature: ______________________________________________________

Billing Address: ___________________________________City:  ________________State:  ____

Zip code: ____________ ------------------------------------------------------

Student Name:  _______________________________________ Birthdate: __________________     

Parent/Guardian Name:   __________________________________________________________

Home Address: ___________________________________City:  ________________State:  _____

Zip code: ______________

Phone #1: ______________________________ Phone #2: ______________________________

E-Mail: ____________________________________________________________________________

Caregiver Name: _______________________________Cell #: __________________________

How did you hear about The Ballet Club?     

IMPORTANT: FOR SUMMER TERMS NO REFUNDS ARE ISSUED AFTER MAY 31, 2020.

Return your completed registration form and payment to The Ballet Club 328 East 61st Street, Second Floor New York, NY 10065

328 East 61st Street, Second Floor, New York, NY 10065

917-281-1030 Studio / 917-281-1032 Fax / 212-204-6348 www.theballetclub.com [email protected]