Adult Summer Intensive Enrollment Application

Student Information

Name

First

Last

Date of Birth

Gender

Optional

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Confirm Email

Cell Phone

Additional Information

Is there any medical information about you that we should be aware of or that would be useful to your teachers?

If there are any conditions that will prevent your full participation in the program, please describe them here.

If there are any dates you will be absent or late, please list them here.

Would you be interested in volunteering with José Mateo Ballet Theatre?

Yes
No

Emergency Contact Information

Emergency Contact Name

First

Last

Relationship

Cell Phone

Demographic Survey

Diversity and inclusion are at the core of José Mateo Ballet Theatre’s mission and commitment to the community. Gathering the information listed below allows us to improve the customer service that we give to all families. In addition, this information will further our diversity and inclusion efforts.

This information will be kept anonymous and only be used to meet the needs of the families we serve.

The primary language spoken in my home is:

What obstacles exist that prevent you from attending a José Mateo Ballet Theatre performance?

My neighborhood is:

(i.e., Winter Hill, Inman Square, Beacon Hill, Hyde Square, etc.)

Enrollment Agreement

I,

Your Name

in José Mateo Ballet Theatre’s 2024 Adult Summer Intensive Program.

I understand that payment is due in full at the time of enrollment.

I understand that, should I, for whatever reason, be unable to participate, withdraw from the program, be dismissed with cause, or be absent from the program, payments will not be refunded.

I am aware that ballet training and the exercises associated with it can place stresses on the body and can risk physical injury. On behalf of the above named student and myself, I assume this risk and agree that José Mateo Ballet Theatre will not be liable in any way for injuries sustained during participation in the program or related activities.

I grant José Mateo Ballet Theatre the right to make and use photographic and audiovisual documentation of me to be used for philanthropic, promotional, and other mission related purposes. (In no case will your identity be disclosed without written consent.)

I understand that the primary method of communication from José Mateo Ballet Theatre is email through Constant Contact or Gmail in order to send announcements and other pertinent studio information.

Signature

Today's Date

Tuition

Tuition Code

Tuition

Price: $400.00

Total

$0.00

Student Information

Additional Information

Emergency Contact Information

Demographic Survey

Enrollment Agreement

I,

in José Mateo Ballet Theatre’s 2024 Adult Summer Intensive Program.

I understand that payment is due in full at the time of enrollment.

I understand that, should I, for whatever reason, be unable to participate, withdraw from the program, be dismissed with cause, or be absent from the program, payments will not be refunded.

I grant José Mateo Ballet Theatre the right to make and use photographic and audiovisual documentation of me to be used for philanthropic, promotional, and other mission related purposes. (In no case will your identity be disclosed without written consent.)

I understand that the primary method of communication from José Mateo Ballet Theatre is email through Constant Contact or Gmail in order to send announcements and other pertinent studio information.

Tuition

Payment Information