Chicago Ballet Arts Summer Class Registration: 2023
Registration for Summer Session II has closed. If you are interested in enrolling in this session, please email us at info@chicagoballetarts.org to confirm what classes are available.
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STUDENT INFORMATION
Student's Last Name: *
Student's First Name: *
Date of Birth: *
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This student is registering for the following:
Summer Session III: July 24 - August 5, 2023
Move with Me
Creative Movement
Ballet Beginnings
Primary Ballet
Ballet 1/2
Ballet 3/4
Ballet 5/6
Ballet 5/6 with pointe or pre-pointe
Ballet 7/8
Ballet 7/8 with pointe
Ballet 7/8 "Flex Pass" - (4 classes per session)
Youth Modern
Teen Modern
Teen Contemporary
Teen Jazz
Name of primary dance school for 2022-23: *
If applicable. If student has not danced previously, please write "n/a."
For dancers ages 6+, please list how many years of previous dance training the student has had.
Please list any specific student information like allergies, injuries, pronouns, or other details that you'd like CBA to be aware of:
PARENT/GUARDIAN INFORMATION
Parent/Guardian's Full Name: *
Additional Parent/Guardian's Full Name
Primary Contact Email: *
Additional Contact Email:
Primary Contact Phone Number: *
Additional Contact Phone Number:
Street Address: *
City and State: *
Zip Code: *
EMERGENCY CONTACT INFORMATION
In the event of an emergency, the parent/guardian's listed will be contacted first. If we are not able to reach them, we will then contact the person listed as the emergency contact.
Emergency Contact's Full Name: *
Emergency Contact's Phone Number: *
LIABILITY & MEDIA 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 my student 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 WAIVER
For the health and safety of our students, staff and visitors, as well as those in the communities we serve, all who may be physically present at Chicago Ballet Arts are asked to confirm:

1. I/we state that I/we have not tested positive for or been diagnosed with COVID-19 within the past 5 days;

2. I/we do not currently have a fever or respiratory illness, including cough, difficulty breathing, or shortness of breath;

3. I/we agree that if any of the above confirmations are untrue at the time of any studio usage, I/we will not enter the studio and will notify Chicago Ballet Arts administration immediately.

4. I/we agree to abide by COVID related policies that CBA may implement in order to create a safe space within the building. This may include mask wearing and other safety measures as recommended by state or federal guidance or as determined by CBA in order to mitigate COVID transmission.

Parents/Guardians acknowledge that they are signing on behalf of their family, including all children in their care that may enter the building, including for any future visits. Individuals acknowledge that they are signing for themselves for any time they enter the building, including for any future visits.
By checking this box I have read and agree to the above COVID-19 waiver and understand that this will serve as my electronic signature. *
Required
OPTIONAL INFORMATION
Please include any additional information you'd like CBA to be aware of regarding this registration.
How did you hear about our summer classes?
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