RMSB Youth Program 2023-2024 Registration Form
Welcome to Ramon Moreno School of Ballet's Youth Program 2023-2024 Registration. Please answer the following questions. Please also print and sign the Contract and Waiver (https://shorturl.at/enxN0) and return it to the RMSB office along with the tuition payment.
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Email *
Youth Program Level (Please contact RMSB to determine your level) *
Student's Information
First Name *
Middle Name
Last Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Address
Street Address *
City *
State *
Zip Code *
Student's Cell Number if any
eg: 650-304-1909
Student's Email if any
Parent/Guardian Information
Parent/Guardian 1 Name *
Parent/Guardian 2 Name
Primary Contact Number *
eg: 650-304-1909
Primary Contact Number Type *
Secondary Contact Number
eg: 650-304-1909
Secondary Contact Type
Email Address 1 *
Email Address 2
Emergency Contact
Please provide any emergency contact other than the parents/guardians above
Name *
Phone Number *
eg: 650-304-1909
Relation to Student *
Medical Information
Please provide essential medical information about the student
Allergies *
Special Needs (including medication) *
Primary Physician's Name *
Primary Physician's Number *
Student Education
Academic School Name
Grade Level as of September 2023 *
Are you a current year-round student at RMSB? *
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