CENTRE FLEX CLASS REGISTRATION. This application must be completed and
returned with a $25 nonrefundable application fee and tuition payment ( ...
Summer Programs e
CENTRE FLEX CLASS REGISTRATION This application must be completed and returned with a $25 nonrefundable application fee and tuition payment (checks made payable to Atlanta Ballet). Additional information on these programs can be viewed at www.atlantaballet.com
Submit Application, $25 Application Fee, and Tuition Payment to: Atlanta Ballet Centre for Dance Education: Summer Programs Michael C. Carlos Dance Centre 1695 Marietta Blvd., NW Atlanta, Georgia 30318 A. Student Information
Student's Name: Date of Birth: Parents/Guardians: Address: City, State, Zip: Home Phone: ( ) Emergency Phone: ( Email Address:*
Age:
Gender:
Cell Phone: (
)
)
*Print Clearly. Confirmation of enrollment and important camp details will be sent via email.
B. Please Indicate which week(s) your child will attend.
CENTRE STUDENTS LEVEL BI - BIII
Must be currently enrolled in ABCDE levels BI*/BII/BIII *student must complete 1 yr in BI to enroll Classes are Monday & Wednesday 5:30 – 7:00pm. Tuition: $190 for 4 Weeks (can mix/match weeks) June 9 & June 11 June 16 & June 18 June 23 & June 25 June 30 & July 2
July 7 & July 9 July 14 & July 16 July 21 & July 23 July 28 & July 30
CENTRE STUDENTS LEVEL BIV - D Must be currently enrolled in ABCDE levels BIV/C/D Classes are Tuesday & Thursday 5:30 – 7:30pm. Tuition: $220 for 4 weeks (can mix/match weeks) June 10 & June 12 June 17 & June 19 June 24 & June 26 July 1 & July 3
July 8 & July 10 July 15 & July 17 July 22 & July 24 July 29 & July 31
C. Tuition Policies & Payment Information
• • •
I understand there are NO refunds. I understand the $25 Application Fee and tuition ($190/4 wks BI-BIII OR $220/4 wks BIV-D) is due in full with submission of this form. I understand this program has a required uniform policy. Students must wear Atlanta Ballet uniform. Classes will be held at the MCC Dance Centre with Principal Faculty Members.
I have read and understand the tuition policies stated above.
Please Initial
________ Enclosed please find my check payment made out to “Atlanta Ballet” in the amount of $
. CK#
________ I authorize Atlanta Ballet to charge my AMEX___VISA___MC___DISC___ in the amount of $
.
Print name as it appears on the card: Credit Card Number:
Exp. Date:
Cardholder’s Email: Once the charge has been processed, Atlanta Ballet will securely dispose of all credit card information.
Signature of Parent/Guardian
Date
Atlanta Ballet Centre for Dance Education | 1695 Marietta Blvd. NW, Atlanta, GA 30318 | P 404.873.5811 | F 404.874.7905 | atlantaballet.com/centre
