Pittsburgh Youth Ballet Company & School

Pittsburgh Youth Ballet School Fall 2011 registration form.
Please fill out the form completely. All fields marked by an * (asterisk) are required.

Student Information:
First Name*
Last Name*
Street Address*
City*
State*
Zip*
School/District*
Grade Level*
Student's Home Phone*
Student's Cell Phone
Email or Text*
Age (YY/MM)*
Date of Birth (MM/DD/YY)*
Height*
Weight*
Leotard Size
T-Shirt size
Class/Classes Interested In
Ballet Schools Attended
Number of Years
Teachers
In case of Emergency*

Parent/Guardian Information:
Mother's Name*
Mother's Cell Phone*
Mother's Email*

Father's Name
Father's Cell Phone
Father's Email

Notes

Once you have submitted your information you will still need to fill out the medical information (download the PDF here), provide copies of your medical insurance cards, and bring payment to the office. Pittsburgh Youth Ballet Company and School also requires a medical, press, and photo waiver to be signed by the parent or guardian.