Registration Form: Lafayette Ballet School

First come first served registrations beginning July 15 with accompanying registration ($30) payment CHECK or MONEY ORDER which is applied to the total tuition due

____________________________________________________
Name

____________________________________________________
Address

____________________________________________________
City State Zip

____________________________________________________
Parent Name (if minor)

____________________________________________________
home phone/ work phone

____________________________________________________
email PLEASE

____________________________________________________
student date of Birth

____________________________________________________
requested class and level - 1st choice

____________________________________________________
requested class (multiple______or 2nd choice________

____________________________________________________
additional classes

____________________________________________________
additional classes

____________________________________________________
additional classes

__________________________________________________
Payment rendered check#

Please send payment of non-refundable $30 registration fee to: Lafayette Ballet Registration, 628 Main Street, Lafayette, IN 47901. We will contact any registrants whose first choice of classes cannot be granted. Registration will be applied toward semester tuition. Please feel free to call the school at 765.423.1633 between 5:00 and 7:00 PM to speak with the secretary. Please keep your account current. We are not structured to send individual billing to students.

LBS WILL CONFIRM REGISTRATION BY EMAIL.
IF THERE ARE CONCERNS AS TO CLASS LEVEL APPROPRIATENESS OR AVAILABILITY
WE WILL CONTACT THE REGISTRANT AS SOON AS POSSIBLE.