Faubourg School of Ballet 2009 - 2010 |
Student's Name _____________________________________________________________ Guardian's Name ___________________________________________________________ Address ____________________________________________________________________ City ____________________________State_______ZIp____________________________ Guardian's Name __________________________________________________________ Home Phone ( )_____________________Work Phone ( )_____________________ Cell Phone ( )_____________________Age_______Birthdate_________________ E-Mail Address ______________________________Level Assignment__________ |
FSB, FBT, and Release:
I agree to hold harmless Faubourg Ballet Theatre (FBT), Faubourg School of Ballet (FSB), Ballet Camp Illinois (BCI), or any affiliates associated with this program, for any damage and/or injury, and/or illness during participation in these programs or any event sponsored by them. I also agree that FBT, FSB, and BCI, or any affiliates associated with these programs, is not responsible if the above student leaves the premises for any reason.
Placement and Alignment Release:
This must be signed in order for the student to attend any class or perform. I understand that correct physical placement and body alignment are necessary in order for all dancer movement to be properly executed. I understand and agree that the instructors will be touching my child within a class setting for correction purposes.
Photographic/Video Release:
From time to time we may use printed photographic and/or video recordings of our students for promotional and/or fund-raising materials. I give Faubourg School of Ballet and Faubourg Theatre my permission for the use of any printed photographic and/or video recordings of the above named student to be used for promotional and/or fund-raising materials. With this release I also understand that we will not receive compensation for the use of said materials.
I hereby acknowledge that I have read and agree with the above information and FSB Policies and Procedures as it pertains to the above named student.
By: _______________________________________________Date:________________________
Signature of parent of guardian
Faubourg School of Ballet, LTD.
2009 - 2010
| Level | Beg | Tech 1 | Tech 2 | Tech 3 | Tech 3A | Tech 4 | Tech 5 |
| Tuition Per Session | $105.00 | $190.00 | $470.00 | $470.00 | $780.00 | $850.00 | $850.00 |
| Unlimited (Classes in assigned level and below) |
N/A | N/A | N/A | $670.00 | N/A | $900.00 | $900.00 |
| **Hourly Rate | N/A | N/A | $12.00 | $12.00 | $12.00 | $12.00 | $12.00 |
| CLASS | CLASS | CLASS | CLASS | CLASS | TOTAL HOURS | |
| MONDAY | ||||||
| TUESDAY | ||||||
| WEDNESDAY | ||||||
| THURSDAY | ||||||
| FRIDAY | ||||||
| SATURDAY |
Total Weekly Hours: __________
Tuition Due: __________
Annual Registration Fee: ____$20.00
Total Due: __________
STUDENT NAME:_______________________________________ LEVEL: _________