Child Information Form

Under the Sea - Ballet Camp August 4-7, Ages 3-5

Participant Information

Participant's Name (First and Last)

Date of Birth

Parent Guardian Information

Parent/Guardia Name

Parent/Guardian Phone

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Emergency Contact

Phone

Authorized Pickup

Name the person(s) authorized to pick up your child (including parents)

*Children will not be allowed to leave with anyone not on this list unless otherwise organized with the teacher.

Authorized Name

Name

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Are there any consistent behaviours your child expresses that you want to let the instructor know about?

Additional Information

Authorization in case of emergency:

In case of an accident (or serious illness), I authorize Canadian School of Ballet staff to contact a physician or ambulance if I, or any other specified guardian, cannot be contacted immediately.

Photo/Video Release

I hereby give my permission for my child/children to be photographed and/or video recorded. I am aware the images may be used for Canadian School of Ballet purposes on the website, in brochures, or on social media to promote awareness of the studio’s programs and services.

Liability Waiver

I understand that while all reasonable precautions will be taken, participation in dance and movement classes involves some risk of injury. I release the Canadian School of Ballet and its staff from liability in the case of injury.

Terms and Conditions

Payment must be received within 24 hours of submitting the registration form to confirm enrolment.
All cancellations are subject to a 25% administrative fee.
Cancellations made less than 4 weeks prior to the start date are eligible for a 50% refund or 75% studio credit.
Cancellations made less than 2 weeks prior to the start date are non-refundable.
Medical or emergency-related cancellations will be issued as a prorated studio credit.

Terms and Conditions

I accept the above Terms and Conditions.

Payment Terms

I understand payment must be sent by e-transfer to info@csballetdance.com with the password "welovecsb" in the amount of $160 within 24 hours for my registration will be confirmed.

Name of parent/guardian agreeing

Email Address

Confirm Email Address