Student Name

First Name

Last Name

Student Date of Birth

Student Current Age

Guardian Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Cell Phone

(###)

###

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Message

Policies & Procedures

I have fully read through, understand and will follow CBM's Policies & Procedures.

I have read and accept CBM's Procedures & Policies.

Medical Release

Medical Release and Authorization: As legal guardian of the child listed on this form I hereby consent for him/her to participate in classes conducted by the Children’s Ballet & Movement Co. Recognizing that any activity involving movement can create the possibility of injury. I will not hold any personnel, officers, agents or instructors liable for any injury that may occur before, during and after class or on the Children’s Ballet & Movement Co. premises. I confirm that my child is in good health and I authorize simple first aid if necessary. I also understand that I am fully responsible for the total tuition session I registered for unless my child is unable to participate for medical reasons. In which case I will provide a signed medical notice from his/ her doctor.

I have read and accept Medical Release and Authorization

Photo/Audio/Video/Social Media Release Authorization

Photo/Audio/Video/Social Media Release Authorization: I hereby irrevocably consent to and authorize the reproduction, publication and/any other use by The Children’s Ballet & Movement Co., his/her licensees and assigns, of the photographs/audio/video, in any medium and for any lawful purpose, including illustration, promotions, advertising, social media or web content, without any royalty or compensation to me. I assign to The Children’s Ballet & Movement Co. any and all rights of ownership to the photographs/audio/video, the transparencies or digital files thereof, and agree that The Children’s Ballet & Movement Co. has full right of lawful disposition in any manner. I waive any right to notice, inspection, or approval of any use of the photographs/audio/video which The Children’s Ballet & Movement Co., may make or authorize, and I release The Children’s Ballet & Movement Co., and his/her licenses and assigns, from any claim or liability arising from or in connection with The Children’s Ballet & Movement Co.’s us of the photographs/audio/video or any alteration, processing or use thereof in composite form, whether intentional or otherwise. CHECK ONLY ONE BOX BELOW.

I have read and accept Photo/Audio/Social Media Release and Authorization.

I have read and deny Photo/Audio/Social Media Release and Authorization.

Checkbox

Option 1

Option 2

Thank you for your registration!

Welcome to our registration page!

-Fall Registration-

2025 Term 1

September 8th to December 20th.

Tuition paid in full is preferred, or pay the deposit and the remaining balance the next month.

if neither option works for you, please email us and we will create a customized payment plan.

Please read our policies & Procedures Page before registering. Click Here.