San Francisco Youth Ballet Academy Registration Form Spring or Summer

Student’s Name :
Parent’s Name :
Birth date :
E-mail :
Address :
City :
Zip code :
Home phone :
Work phone :
Emergency Contact Name :
Emergency Contact Phone :
What class, camp, and/or workshop are you registering for?
(Student will not be admitted to class unless this portion of the form is completed) 911 will be called in extreme emergency. Health/Other issues teacher should know about (i.e. medication, allergies, physical):
I am interested in volunteering for SFYBT performances and/or becoming a member of the SFYBT board Yes No
List Special Skills/Interests:
I have received & read and understand the policies of SFYBA. Yes No
I understand the tuition payment schedule. Yes No
I hereby authorize SFYBA to use any and all photographs taken of my child. Yes No
(Signature Parent/Guardian)
(Date)
SFYBA reserves the right to deny services for non-compliance with the academy policies and philosophy.
Note: SFYBA will send an email to confirm registration.