CBA Adult Intensive Registration: 2024
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DANCER'S INFORMATION
Last Name: *
First Name: *
I am registering for: *
Email: *
Phone Number: *
Street Address: *
City and State: *
Zip Code: *
Please list any allergies, injuries or other information that you'd like CBA to be aware of:
I will make the tuition payment via: *
EMERGENCY CONTACT INFORMATION
In the event of an emergency, please include the information of the person you'd like us to call first.
Emergency Contact's Full Name: *
Emergency Contact's Phone Number: *
WAIVER
I hereby release Chicago Ballet Arts, its agents and employees, from all liability for personal injury, illness, or property loss or damage. I give consent for staff and personnel to take and use photographs and/or video of me for CBA's promotional purposes, including for use on its website, social media, posters and other materials.

By checking this box I have read and agree to the above waiver and understand that this will serve as my electronic signature. *
Required
COVID-19 POLICY
For the health and safety of our students, staff and visitors, as well as those in the communities we serve, we ask that students follow CDC guidelines in the event of a positive COVID test or known exposure.
By checking this box I have read and agree to the above COVID-19 policy and understand that this will serve as my electronic signature. *
Required
OPTIONAL INFORMATION
How did you hear about our summer intensive?
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