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Flora Leptak-Moreau
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Summer DanceCare Intensive Registration
DanceCare Registration
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Student's First Name
Student's Last Name
Age
School
Parent's Name
Parent Email
Emergency Phone Contact
Address
Parent's Phone
Session 1 (June)
Session 2 (July)
What are you looking forward to the most?
Choose Period and Time of Day
June (Available PM Only)
July (AM Only)
July (PM Only)
July (Full Day)
One Week June PM
Two Weeks June PM
Three Weeks June PM
One Week July AM Only
One Week July PM Only
One Week July AM & PM
Two Weeks July AM
Two Weeks July PM
Two Weeks July AM & PM
Three Weeks July AM
Three Weeks July PM
Three Weeks July AM & PM
Flex Card ( 4 (1hr) classes)
Flex Card ( 8 (1hr) classes)
Select: Part-Time or Full Time
Choose an option
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Tell us which dance styles you have taken before
Ballet
Creative
Afro-Caribbean Dance
Contemporary
By sending this registration form, you give Ballet Caraibes permission to use dance images and video of your child on our website or on media materials that may appear on social network not limited to Youtube or Facebook. Thanks for your support!I agree to images and video the terms & conditions.
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