Register

2019/20 School Year

Barre None Ballet Online Registration

* Indicates required field

Student 1 *

First

Last

Student 1 Birthdate *

Student Phone *

Student 2 *

First

Last

Student 2 Birthdate *

Phone Number *

Student 3 *

First

Last

Student 3 Birthdate *

Phone Number *

Parent or Gardian *

First

Last

Phone Number *

Texts OK? *

Yes No

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Additional Parent or Guardian *

First

Last

Additional Parent or Guardian Phone *

Class 3 *

Class 4 *

Class 5 *

Class 1 *

Class 2 *

I hereby release Loren Harn, Barre None Ballet, Room To Move Studio & All Associates from all liability for personal injury, illness, or property loss/damage. ~ I certify that the named student(s) is in good health and capable of participating in classes. ~ I agree to allow photographs to be taken for promotional use (names will be withheld). ~ I agree to allow my email address to be added to the studio mailing lists. I acknowledge and understand that the full tuition amount is due regardless of attendance. ~ I take full financial responsibility for all tuition accrued by named student(s). And that there are NO REFUNDS*

Check to agree to terms listed above *

I agree

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