2008
SUMMER INTENSIVE PROGRAM
CLASSICAL BALLET SEMINAR OF RUSSIAN TECHNIQUE

IMPORTANT: All the information marked with (*) is required. In case it does not apply, please enter "N/A"

Student Information

Name (*)

Lastname (*)

Birth Date (*)

Address Line 1 (*)

Address Line 2

City (*)

State (*)

Zip Code (*)

Country (*)

Home Phone (*)

Mobile Phone (*)

Email

Estudent Photography (*)
In First Arabesque
width: 400px
height: 300px
resolution: 72dpi

Student Dance Experience

Present Ballet School (*)

Level(*)

Current Teacher(s) (*)

Past summer program experience (*)

Have you had the following trainings? Indicate years (*)

Pointes
Pas de Deux
Character
Modern		style
Pilates
Flamenco
Other		name

Languages Spoken (*)

Parents Information

Mothers Name (*)

Ocuppation (*)

Work/Mobile Phone (*)

Email Address (*)

Fathers Name (*)

Ocupation (*)

Work/Mobile phone (*)

Email Address (*)

Housing and Scholarship

Housing (*)

	I would like to stay with a hosting family
	I am a local student or plan to live locally for the summer

Scholarship Aid

If accepted, I would like to apply for financial assistance. I understand it is limited and that I should also seek alternate sources of funding. Scholarship does not include housing or transportation.

General Release Waiver of Claim and Assumption of Risk Agreement

I, HEREBY voluntarily assume any and all risks, including property and injuries sustained or illnesses contracted by me or my child which may be caused as a result of participation or attempt to participate in any and all dance and/or performances (including any period traveling to and from the events described) by Arts Ballet Theatre of Florida/ The Vaganova Ballet Academy , its agents, employees or otherwise.

IN CONSIDERATION Arts Ballet Theatre of Florida/ The Vaganova Ballet Academy permitting me or a family member to participate in dance classes and performances, I, hereby, fully, finally and forever voluntarily release, waive and discharge Arts Ballet Theatre of Florida/ The Vaganova Ballet Academy, their lessors, heirs, successors and/or assigns from any and all claims, demands, damages and causes of action of any nature whatsoever which I, or by reason of my participation in said dance and programs, may deem to cause.

BY CLICKING the following button I hereby acknowledge that I have read the foregoing, understand the terms contained herein, and this General release, Waiver of Claim and Assumption of Risk Agreement has been executed voluntarily.

Participant's parent's name or guardian (if under 18 yrs of age)
*Todays Date ()**	(month/day/year)

Checks or money orders in the amount of $ 25.00 must be made to Arts Ballet Theatre of Florida. Please send your payment to 2646 NE 189th Terrace Miami, FL 33180 No application will be considered without a payment

2008 SUMMER INTENSIVE PROGRAM CLASSICAL BALLET SEMINAR OF RUSSIAN TECHNIQUE

2008
SUMMER INTENSIVE PROGRAM
CLASSICAL BALLET SEMINAR OF RUSSIAN TECHNIQUE