2020-21 General Program Registration Form Page (Levels 1-8, Accelerated & ASITP)

LEVELS 1-8 & ASITP REGISTRATION

STUDENT CONTACT INFORMATION:

Student Name:*

First

Last

Gender*

Female

Male

Date of Birth:*

day

/

month

/

year

Age*

Student Email:

Student Phone:

Academic School Student is Attending:*

PRIMARY PARENT/GUARDIAN CONTACT INFORMATION:

Primary Parent/Guardian Name:*

First

Last

Primary Parent/Guardian Address:*

Street Address City State / Province / Region Postal / Zip Code Country

Primary Parent/Guardian Home Phone:

Area Code

-

Phone Number

Primary Parent/Guardian Cell Phone:*

Area Code

-

Phone Number

Primary Parent/Guardian Email:*

SECONDARY PARENT/GUARDIAN CONTACT INFORMATION:

Secondary Parent/Guardian Name:

First

Last

Secondary Parent/Guardian Address:

Street Address City State / Province / Region Postal / Zip Code Country

Secondary Parent/Guardian E-mail:

Secondary Parent/Guardian Phone:

EMERGENCY CONTACT:

Emergency Contact Name:*

First

Last

Emergency Contact Relation to Student:*

Emergency Contact Phone:*

PROGRAM SELECTION:

All classes run from September 2020 to June 2021.

Please note, class schedule may be subject to change until October 1, 2020.

Optional Add-On Class Selection (if NOT choosing the Accelerated Stream or the Accelerated Stream PLUS Youth Company as listed above):

Optional Add-On Jazz (for Levels 1-8)

Optional Add-On Intensive Training Ballet Class (for Levels 2-8)

Optional Add-On Contemporary (for Levels 5-8)

Please Note: Final level placement determined by faculty after first class

PAYMENT INFORMATION:

Annual Payment can be made in one lump sum payment by:

-Cheque

Monthly Payment can be submitted by:

-Cheque

-Pre-Authorized Debit

Fees for September/June and Registration due upon registration. Following monthly payments charged on the 1st of each month, October to May.

Tuition is due in full at the time of registration. However, in an attempt to make tuition payments more convenient for families, VAB parents or students are eligible to arrange a monthly payment option with the school. This monthly payment is spread out in equal installments over 10 months and is not dependent on how many classes are held per month. These payment methods are available only to families whose accounts are in good standing and who do not have a history of missed or nsf payments. Tuition owing from previous years or terms are payable before registration is permitted for the following year or before student can continue in the second term.

You are not fully registered until payment has been set in place. This means a lump sum payment has been processed, monthly post-dated cheques or Pre-Authorized Debit has been submitted/set-up, and the post-dated payment for Recital Package fee (and costume fees for optional add-on classes if applicable) has been submitted. Please contact the office if you have any questions.

Payment Fequency:*

Full Payment

Monthly Payments

Payment Method:*

Cheque

Pre-Authorized Debit

Discounts:

Sibling Discount (multiple siblings enrolled) - 10% off sibling with lesser tution amount

Name of Sibling(s):

RECITAL PACKAGE:

Students will receive a High Definition Link of the 2021 Recital Performances, a commemorative VAB sweatshirt and purchase of their recital costume. Additional costume fees will apply to students enrolled in optional add-on classes or Accelerated streams.

For more information on Recital Package pricing and payment due dates, please visit our General Program Tuition page.

I agree to Recital Package Fee amounts and payment due dates:*

Agree

Recital Package -Sweatshirt Size: Please allow room for growth as sweatshirts will not be handed out until the end of the dance year.*

MEDICAL INFORMATION:

Medical Conditions and Allergies:

Current Medications:

Musculoskeletal Injuries (Past or Present):

I have chosen to vaccinate my child:

Yes

No

MEDICAL INSURANCE IS MANDATORY IN CANADA and mandatory for participation in Victoria Academy of Ballet (“VAB”) programs. Participants in VAB programs, or their guardians, must assume the risk of injury associated with participation in rigorous physical activity programs, including but not limited to slips, falls, incidental contact, and any injuries, damage, and expenses resulting therefrom. By participating in a VAB program, I hereby assume said risk and release VAB and its officers, directors, employees, contractors, agents, students, host families, affiliates, and assigns from liability for injury, damage, medical expenses, other expenses, and costs, however arising. All students are responsible for ensuring that they have and maintain medical coverage either with British Columbia or their home province. *

Agree

Personal health care number*

Province where health card was issued:*

I authorize VAB or its representative to authorize necessary medical treatment for me if I am unable to give authorization and consent at the time. If under the age of 19, the parent and/or guardian cannot be contacted or reached in a timely manner to authorize medical treatment, I hereby authorize VAB or its representative to authorize necessary medical treatment where such treatment is recommended by hospital staff or a physician.*

Agree

If there are treatments which I am not willing to authorize under any, including potentially fatal, circumstances, those treatments are:

If VAB authorizes treatment under the foregoing authorization, I hereby release, on my own behalf and/or on behalf of the program participant of whom I am the legal guardian, VAB and its officers, directors, employees, contractors, agents, students, host families, affiliates, and assigns from liability for injury, damage, medical expenses, other expenses, and costs, however arising. This authorization and release shall be valid for the full duration of the student's participation in any Victoria Academy of Ballet program.*

Agree

AGREEMENTS:

I have read and understand the refund policy for my child's program (information available on the VAB website under "General Program Tuition"):*

Agree

I acknowledge and agree that the Registration and Recital Package fees are non-refundable and non-transferable. *

Agree

I understand that if I choose the monthly payment option, that the payments are equally spaced across 10 months, no matter how many classes occur in each month.*

Agree

I understand that in the months leading to the May year end recital, my child's regular attendance is mandatory. If my child misses more than 3 classes (unexcused) in this time period then they may be removed from the performance at the discretion of the faculty.*

Agree

I permit VAB to use images of my child on social media or in professional marketing materials. Student names will not be used/identified.

Yes

No

How did you hear about VAB?:*

By agreeing to this Application, we hereby attest to the accuracy of the information provided herein, and agree to all terms and releases and give all authorizations contained herein.*

Agree

Date of Agreement:*

Please click SUBMIT to finish providing your information. Once you have done this, please click on ADD TO CART to finalize payment of your registration fee.

Please note that all registration fees are NON-REFUNDABLE.

GENERAL PROGRAM

REGISTRATION FEE – $40