BALLET AT THE PARK
17535 SW 95th Ave, Palmetto Bay, FL 33157 · 786.343.2184 · info@balletatthepark.com
Student Registration Form
Dancer's Name: ____________________________________________
Date of Birth: _______________ Age: ________
Parent/Guardian Name: ____________________________________________
Address: ____________________________________________________________
Phone: _____________________ Email: ____________________________
Emergency Contact (name & phone): ______________________________________
Class(es) of Interest (check all that apply)
□ Classical Ballet
□ Jazz
□ Pointe
□ Character
□ Contemporary
□ Adult Classes
□ Summer Session
□ Other: ______________
Tuition Plan
□ 1 Hour / Week — $65
□ 2 Hours / Week — $100
□ 3 Hours / Week — $130
□ 4 Hours / Week — $150
□ 5 Hours / Week — $165
□ 6 Hours / Week — $180
Annual registration fee: $45 per dancer (one-time, separate from class tuition).
By signing below, I acknowledge that Ballet At The Park is a 501(c)(3) nonprofit organization and agree to the studio's tuition, attendance and photo/video release policies.
____________________________
Parent/Guardian Signature
____________________________
Date