STUDENT INFORMATION

Name*

First Last

Preferred Name for Name Tag/Roster

If nothing is entered here, we will use the first name listed above.

Date of Birth*

Pronouns*

Example: she/her/hers

Level of Ballet Experience*

Which level would you consider yourself to be? Please note that foundational knowledge of ballet is needed to register for this intensive.

Beginner (waitlisted 3/12/25)

Intermediate

Full-Day or Half-Day*

Please select whether you are registering for the full-day or half-day program.

Full-Day

Half-Day

Address*

Street Address Address Line 2 City State ZIP Code

Email Address*

Primary Phone*

This phone number will be used as the primary contact.

Alternate Phone

If entering an alternate phone, please select below the type of phone number.

Alternate Phone Type

Mobile

Home

Work

Health Information

Emergency Contact*

In the event of an emergency, please contact:

First Last

Emergency Contact Relationship to Student*

Emergency Contact Phone*

Emergency Contact Email*

Please let us know about any health conditions we should keep in mind during the ABSI.*

Please list all known allergies, including reaction and treatment:*

WAIVER AND RELEASE

Please read carefully before signing. This is a release of liability and waiver of certain legal rights.

Liability Release: As the enrolled participant, I agree and understand that dance/fitness training is a potentially hazardous activity. I recognize that there are risks inherent in dance training, including but not limited to serious physical injury. The participant hereby agrees to participate in activities of the Kansas City Ballet School (KCBS) and hereby agrees to indemnify and hold harmless Kansas City Ballet (KCB), KCBS, and the instructors, officers, directors, agents and employees of each against any liability resulting from any injury that may occur to the participant while participating in activities of KCBS. The participant also agrees to indemnify KCB and KCBS for any damages incurred arising from any claims, demand, action or course of action by the participant.

Signature*

By printing my name below, I acknowledge that I have read the above releases and sign with the full knowledge of their content and significance. Both parties agree that a printed name is the legal equivalent of a manual/handwritten signature on this form.

PAYMENT INFORMATION

A non-refundable deposit is required to reserve a place in the program; $150 for the full day or $75 for the half day. The deposit is applied toward the total tuition cost. A link to pay the deposit will be provided upon submission of this form. The balance of fees is due by June 30, 2025.

How would you like to make your deposit payment?*

Pay by credit card

Will mail a check

How would you like to make the remaining payments?*

I want KCBS to charge my card on file

I want to initiate my own payments

As a reminder, submission of this form and payment of deposits is NOT confirmation of registration – an enrollment confirmation email will be sent once your spot is secured.

Please allow our staff ten (10) business days to process registration after you have submitted the form and deposits. If you have not received the enrollment confirmation email by then, please contact us at school@kcballet.org or 816-931-2299 x2.

Box Office

2025 Adult Ballet Summer Intensive Registration