EmailMe Form - ABA Nutcracker Audition Registration

Dancer's Information

Student Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Student's Email

Student's Cell Phone

### - ### - ####

Student's Home Phone

### - ### - ####

Student's Date of Birth *

MM / DD / YYYY

Age *

Height *

Gender *

Boy

Girl

Other

Ethnicity *

Academic School *

Grade *

Physician's Name *

Physician's Phone *

### - ### - ####

Does the student have any medical concerns of which we should be aware? *

Dance Background information

Current Dance Studio *

Dance Class Level *

How many classes a week are you currently taking? *

Please explain your performance experience. *

Rehearsal Conflicts

Do you have any rehearsal conflicts? *

(Nutcracker rehearsals are primarily held on Saturdays but rehearsal may also be scheduled during the week)

Emergency Information

Emergency Contact Name *

First Last

Relationship to Student *

Phone *

### - ### - ####

Guardian Contact #1

Name *

First Last

Relationship to Student *

Email *

Cell Phone *

### - ### - ####

Work Phone

### - ### - ####

Guardian Contact #2

Name

First Last

Relationship to Student

Email

Cell Phone

### - ### - ####

Work Phone

### - ### - ####

Other Information

How did you hear about this audition? *

$10 Performance Audition Fee

I understand that to participate in this audition and to be considered for a roll in the Nutcracker, I will pay the . Please know that this form will automatically redirect you to PayPal once you have clicked "Submit." If you would prefer to pay with Venmo, simply close the PayPal window and submit your payment through Venmo (@ABA-StPete) instead.

What is your preferred payment method? *

PayPal

Venmo (@ABA-StPete)

Cash

Check

Do you agree to pay the $10 Performance Audition Fee? *

YES, I will pay the $10 fee

NO, I will not pay the $10 fee

Please read and initiial below.

I give the child identified in this form permission to audition for The Academy of Ballet Art's Nutcracker performance. If my child is accepted, I will be responsible for ensuring my child’s attendance at ALL rehearsals. If necessary, I will provide adult supervision during rehearsals. I understand that if my child is absent from rehearsals, or fails to abide by the behavior code that they may be replaced.

Initial Here *

Please read and initiial below.

If my child is currently a student at The Academy of Ballet Arts, Inc., I also agree that their monthly tuition rate will not change while attending rehearsals and/or performances. Participation in the Nutcracker and other performances is considered extra training for those who are accepted.

Initial Here

Please read and sign below.

By your signature below, you acknowledge that photographs and/or video may be taken of the student, and that The Academy of Ballet Arts, Inc. may use such media and/or likenesses in print, on the Internet, and/or for training purposes. If you have an objection to the use of your student’s image, please contact The Academy of Ballet Arts, Inc. before completing this form.

The Academy of Ballet Arts, Inc. does not discriminate on the basis of race, color, gender, marital status, age, sexual orientation, disability, religious preference and national or ethnic origin.

Signature: please print your full name. *

Date Time *

MM / DD / YYYY

Dancer's Information

Dance Background information

Rehearsal Conflicts

Emergency Information

Guardian Contact #1

Guardian Contact #2

Other Information

$10 Performance Audition Fee

Please read and initiial below.

Please read and initiial below.

Please read and sign below.

***Please only click the "Submit" button once.***

Please only click the "Submit" button once.