What Makes Us Special

Student Full Name
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Date of Birth
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Parent/Guardian Email Address
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Years of Previous Ballet Experience
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Little to None
1 Year
2 Years
3 Years
4 Years
5 years or More
Parent/Guardian Full Name (If student is under 18)
Address
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- Street Address
- Address Line 2
- City
- State / Province / Region
- Postal / Zip Code
- Country
Parent/Guardian Cell Phone Number
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Parent/Guardian Address (If different from Student)
Select a Choice
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Student Cell Phone (If Applicable)
Student E-mail (If Applicable)
Preferred Schedule of Payment
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Annual Tuition- 1 payment due August 14th (10% discount in rate)
Trimester Tuition- Due August 14th, November 13th & February 12th
Emergency Contact Information (Name, Phone Number, & Relationship)
Allergies or Medical Conditions
Comments
Photo Release Consent -- Palmetto Conservatory of Dance has my permission to use my or my child’s photograph publically to promote the school. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
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I Agree
I Do Not Agree
Parent/Guardian Electronic Signature
Please click on the checkbox to continue
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