Registration for Neglia Ballet's FREE Summer Boys Program "Boys Dance Too!"
This all-boys program runs Monday - Friday from June 28 - July 9, 2021, from 4:15 pm - 5:15 pm

By submitting this form you are agreeing to the full terms of the program which include full participation for the 2 weeks, punctual arrival and departure, and that the participant has an interest in ballet and dance.

While the program is tuition-free, participants are required to submit the $40 registration fee which will be applied to the 2021-22 Conservatory year should they decide to continue with ballet classes at Neglia.
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Email *
Student Name *
Last name, First name
Student Birthdate (MM/DD/YYYY) *
Age as of June 28, 2021 *
Current Academic School *
Grade in School *
Why does your son want to participate in the boys summer ballet program? *
List previous dance experience if applicable. *
Dance experience is NOT needed to participate in this program. If your son has not danced before, please enter "none". If your son has had dance experience please include the style of dance, and the studio / school where he took class.
Please list any challenges, allergies, disabilities, or chronic illnesses including nervous, or emotional conditions that might affect study. *
If not applicable enter "none"
Parent/ Guardian #1 *
Cell Phone Number of Parent/ Guardian #1 *
(xxx) xxx-xxxx
Email of Parent/ Guardian #1 *
Parent/ Guardian #2
Cell Phone Number of Parent/ Guardian #2
(xxx) xxx-xxxx
Email of Parent/ Guardian #2
Street Address *
Address of where the student resides
City/ Town of Residence *
State of Residence *
Zip Code *
Emergency Contact *
Name and Phone Number (other than previously listed parent/ guardian)
Ethnic/ Racial Background *
Beneficiary statistics required by Erie County and Other Funders. Information on this form is confidential. Statistics are only reported in aggregate/total. Please check the appropriate box.
Gross Family Income *
Beneficiary statistics required by Erie County and Other Funders. Information on this form is confidential. Statistics are only reported in aggregate/total. Please check the appropriate box.
How did you hear about Neglia's Boys Summer Program? *
Briefly describe where or from whom you heard about the program. (School Teacher, Flyer, Facebook, Newspaper, Neglia Newletter or website...)
If your son has the interest to pursue training in dance, will your family be supportive of the required amount of hours recommended by the Neglia Staff? *
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