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Academy of Ballet
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CLARA 5th Annual Winter Show
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tion
Summer Camp
2024
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Students First Name
Students Last Name
Fathers First and Last name
Mothers First and Last name
Email
Phone
Students Birthday
Address
Emergency Contact Name
Emergency Phone Number
Previous dance training if yes, how many years?
List any physical limitations or disabilities that would be affected by dance exercise
I am registering for which class(es) If registering for summer camp, just put "summer camp" and what age group **If you have not talked to the Artistic Director (Bethany) about class assignment, please do so before registering*
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