Providence Ballet

Providence location 2009

 Providence Ballet 

S U M M E R 2009, R E G I S T R A T I O N   F O R M

 

194 Oxford St. Providence, RI 02905 (401) 861-4842 ProvBallet@cox.net

 

 

Child’s name_____________________________________DOB_________________________

 

Parent/Guardian _______________________________________________________________

 

Address_____________________________________________________________________

 

City___________________________________State____________Zip___________________

 

Telephone # __________________ cell # ____________________Emergency #_____________

 

E-mail (optional) ______________________________________________________________

 

REGISTERING FOR

 

Broadway Dance Camp I (July 13-July 17) (9:30-3:00) (10-14 yrs) $220.00_______________________

 

Intermediate I/II Camp (July 27- Aug. 7, 2 weeks) (9:30-5:00) (12-14 yrs) $600.00_________________

 

Ballet III Camp (Aug.10 - Aug.14) (10:00-3:00) (8-10 yrs) $200.00_____________________________

 

Ballet V Camp (Aug.17-Aug.21) (9:30-4:00) (11-13 yrs) $260.00 ______________________________

 

Minimum enrollments must be met by June 15, 2009.

 

                                                                                                                                           Tuition, ___________

 

 

                                                    

 

Less deposit due at signing ($50.00 non-refundable deposit per camp)                             ___________

 

                                                                                                                                      Balance,  ____________

 

Payment Method; Check/Cash   ONLY                                         check #_________ Cash__________

 

Disclaimer / Waiver of Liability

 

  The undersigned acknowledges that the participation in dance education involves strenuous physical activity and that Providence Ballet, Inc. and its employees will not be held responsible for injury of any kind as a result of this participation. Also, Providence Ballet, Inc. and its employees will not be responsible for administrating prescription medication. For the common welfare, it is necessary to disclose any conditions, physical or otherwise, that may affect the undersigned and/or other participants

Signature of Parent/Guardian _______________________________date _______________

  

East Greenwich location 2009

 

 S U M M E R 2009, R E G I S T R A T I O N   F O R M

 

3355 South County Trail East Greenwich, RI 02818 (401) 886-7827 ProvBallet@cox.net

 

 

Child’s name_____________________________________DOB_________________________

 

Parent/Guardian _______________________________________________________________

 

Address_____________________________________________________________________

 

City___________________________________State____________Zip___________________

 

Telephone # __________________ cell # ____________________Emergency #_____________

 

E-mail _______________________________________________________________________

 

 

Ballet III/IV Camp (July 20- July 24) (10:00-3:00) (9-11 yrs) $200.00_________________________

 

Creative Arts Camp (Aug. 3- Aug. 7) (10:00-12:00) (3-5 yrs) $100.00 ________________________

 

Creative Arts Camp (Aug. 17-Aug. 21) (10:00-12:00) (3-5 yrs) $100.00 _______________________

 

Dancing Like Swans (class) (July 13 –Aug.3) (3:30-5:00 Monday’s) 6-8 yrs) $60.00 _____________

 

Dancing Stories (class) (July 13- Aug.3) (3:30-5:00 Tuesday’s) (3-5 yrs) $60.00 ________________

 

 

Minimum enrollments must be met by June 15, 2009

                                                                                                                                         Tuition,  ___________

 

Less deposit due at signing ($50.00 non-refundable deposit)                                                     __________

 

                                                                                                                                       Balance,  ____________

 

Payment Method: Check #_______ Cash_______ Card # __________________________exp. Date _________

 

Disclaimer / Waiver of Liability

  The undersigned acknowledges that the participation in dance education involves strenuous physical activity and that Providence Ballet, Inc. and its employees will not be held responsible for injury of any kind as a result of this participation. Also, Providence Ballet, Inc. and its employees will not be responsible for administrating prescription medication. For the common welfare, it is necessary to disclose any conditions, physical or otherwise, that may affect the undersigned and/or other participants.

 

 

  

Signature of Parent/Guardian __________________________________________Date ________________

 

Welcome

Upcoming Events

Friday, Mar 26 at 8:00 pm
Saturday, Mar 27 at 8:00 pm
Saturday, Apr 10 at 7:30 pm
Sunday, Apr 11 at 2:00 pm

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