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2023 Summer Youth Training INTERMEDIATE Registration
Contact Information
Dancer Name
*
First Name
Last Name
Dancer Age
*
Dancer Gender
Male
Female
Non-Binary
Unknown
Other
Decline to state
Dancer Race
Asian/Asian Americans/Pacific Islander
Black/African American/African
Hispanic/Latino/Latina/Latinx
Native American/American Indian/Indigenous
White/Caucasian/European
Multi-Racial or Multi-Ethnic (2 or more races or ethnicities)
Unknown
Decline to state
Other
Does the dancer have any disabilities, allergies, or other necessary accommodations?
Dancer's Regular Dance Studio
*
Dancer's Regular Dance Teacher
*
Parent Name
*
First Name
Last Name
Parent Email
*
Verify Email
*
Parent Phone Number
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Registering For
*
6/19 - 7/21 only
8/2 & 8/9 only
All 7 weeks
Payment
$180
-
6/21 - 7/19 only
$72
-
8/2 & 8/9 only
$252
-
all 7 weeks
I do not wish to pay online but will pay by cash or check by the following date:
(mm/dd/yyyy)
I, the purchaser, agree:
*
TO ASSUME ALL RISK AND DANGER INCIDENTAL TO EVENT, CLASS OR TRAINING WHETHER OCCURRING PRIOR TO, DURING, OR AFTER SAID EVENT.
TO ASSUME ALL RISK AND DANGER OF INJURY AND ILLNESS AND AGREE THAT THE MANAGEMENT -- North Pointe Ballet, and associated parties for those organizations--ARE NOT RESPONSIBLE OR LIABLE FOR ANY INJURIES OR ILLNESS RESULTING FROM SUCH CAUSES.
THAT NORTH POINTE BALLET HAS TAKEN REASONABLE MEASURES TO ENSURE MY SAFETY.
THAT MY NAME, LIKENESS, IMAGE, APPEARANCE, AND/OR PERFORMANCE MAY BE RECORDED IN PHOTOGRAPHIC, AUDIO, OR VIDEO AS A RESULT OF REHEARSING AND PERFORMING WITH NORTH POINTE BALLET (NPB). I GRANT NPB AND ITS AFFILIATES THE RIGHT TO USE THOSE RECORDING IN ANY FORMAT, NOW OR LATER DEVELOPED.
Add 3% to my total amount to help cover the payment processing fees