Online Student Registration Form

If you do not wish to submit online, you may simply print your completed form and send it with payment and signature to VBTS by mail.

Summer Registration 2011
Student Information
Full Name: D.O.B.: Gender: School Grade:
Previous Dance School: Years of study:
 
Parent/Guardian Information(If applicable)
Mother: Home #: Work #: Mobile:
Father: Home #: Work #: Mobile:
Emergency Contact: Home #: Work #: Mobile:
 
Address Information
Student Address: Billing Address(if different)
City/State/Zip: City/State/Zip:
Email: Email:
 
Summer Class & Camp Information
Young Dancers    
Class Session Campus Session Cost Register
CID II/CIB Session 1
June 29-July 20 (4 weeks)		 Essex $56.00
CID I/II

Session 1
July 7-July 28 (4 weeks)

 Shelburne $56.00
CIB Session 1
July 7-July 28 (4 weeks)		 Shelburne $56.00
   
Pre-Professional Ballet Technique  
Class Session Campus Session Cost Register
Intermediate Ballet Session 2 ONLY  
Aug 2-Aug 25
(4 weeks)

   Essex $65.00
1 class per week 		1
$125.00
2 classes per week 		2
Advanced Ballet Session 2 ONLY  
Aug 2-Aug 25
(4 weeks)		   Essex $65.00
1 class per week		 1
$125.00
2 classes per week 		2
         
Adult Ballet Only        
        Register
Adult Ballet Session 1
June 27-July 27
(4 weeks-no class July 4 & 6)

 Essex $65.00
1 class per week		 1
$125.00
2 classes per week 		2
Session 2
August 1-August 24 (4 weeks)
 Essex $65.00
1 class per week		 1
$125.00
2 classes per week 		2
         
Yoga & Pilates Campus Session Cost Register

TBD-Info To Come.

Essex per class  
       
Summer Intensives & Camp        
Camp Session Date Campus Session Cost Register
Mini Summer Intensive
June 13-17 Monday-Friday Essex $95.00/week
         
Dance Camp with Mel Hendrix
June 6-June 10
"Fairy Tale Ballets"
9:30-10:30 am Ages 3 & 4
11:00-12:00 am Ages 5 & 6

 Essex $80.00/week 9am
11am
Dance Camp with Mel Hendrix August 15-August 19
"Cinderella Camp"
8:30-9:45am Ages 4 & 5 		Essex $80.00/week
Dance Camp with Mel Hendrix August 15-August 19  
"Nutcracker Camp"
10:15-11:30am Ages 5 & 6

 Essex $80.00/week
Dance Camp with Mel Hendrix
August 22-August 26
“Sleeping Beauty Camp”
8:30-9:45am Ages 4 & 5
Essex $80.00/week
August 22-August 26
“Firebird Camp”
10:15-11:30 am Ages 5 & 6
         

Dance Camp with Annette Urbschat

July 11-15 Monday-Friday
“Arabian Nights Camp”
9:00am-12:00pm Ages 6 & 7

 Shelburne $195.00
Dance Camp with Annette Urbschat July 18-July 22 Monday-Friday
“Coppelia Camp”
9:00am-12:00pm Ages 4 & 5		 Shelburne $195.00
Dance Camp with Annette Urbschat

July 25-July 29 Monday-Friday
“Nutcracker Camp”
9:00am-12:00pm Ages 4 & 5

 Shelburne $195.00
   
Payment Information
VISA Mastercard Discover Check
Name on Card Account # Ex. Date
I authorize VBTS to charge my account for the amount listed in the worksheet above.
Please read the following VBTS Policies information. You must agree to the terms in order for your registration to be submitted.
VBTS Policy Acknowledgment and Release of Liability
"I have read the Vermont Ballet Theater School program materials and agree to abide by the protocol and etiquette requirements. I have examined the Academic Year Tuition payment policies. I understand them and agree to abide by their terms. I am aware that ballet dancing and the gymnastic exercise associated with it place unusual stress on the body and carry with them the risk of physical injury. On behalf of myself and/or my child, I assume the risk and agree that Vermont Ballet Theater school, Board of Directors, faculty and any of the chaperones and agents shall not be liable in any way for any injuries sustained, or loss of property at the school or any of its functions."
By checking this box, you agree to the terms listed in the VBTS Policy Acknowledgment and Release of Liability and will be dated as the day the registration form is submitted to VBTS. I agree.
Printed versions must sign here agreeing to the terms listed above. Signature & Date ______________________________________________
Unsigned applications will not be registered.

Mailing Address: P.O. Box 8147 Essex, Vermont 05451 Phone: (802)878.2941 FAX: (802)879.7001
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