Etudes de Ballet & Co.
3285 Pine Ridge Road, Naples, FL 34109 239-593-8280 / 239-593-8284 fax - www. etudesdeballet.com
Student/Participant name __________________________________________________________
Birthday _______________ age _______ sex __
Parent or Guardian _______________________________ home phone ________________________
Home address ______________________________________________________ zip code ___________
Business phone _______________________________ cell phone ______________________________
Home email address _______________________________________________________
In event of emergency and parent or guardian can not be reached, notify:
Name ________________________ home phone __________________ business phone __________
Does the participant have any allergies or medical conditions of which we should be aware? If
Yes, please describe: _________________________________________________________
Attached is my registration fee of $______________ good through August, 200_____.
Waiver of injury: I, the undersigned, do hereby voluntarily submit my child and/or myself for attendance and participation in the Etudes de Ballet & Co. dance and other programs and do hereby assume full responsibility for any and all damages, injuries or losses that she/he/I may sustain or incur in anyway while attending or participating in any Etudes de Ballet & Co. classes or activities both in and away from the studio. I, the undersigned, do hereby waive all claims against the instructors, owners and/or operators, individually or otherwise, of Etudes de Ballet & Co. or J.D. Burt Company, Inc., for any injuries she/he/I may sustain while attending or participating in said programs, I fully understand that any medical treatment given to my child or myself will be for first aid only, but I give emergency treatment authorization if I cannot be reached. This form can be photocopied for emergency treatment.
Additionally, I have read and understand the Etudes de Ballet code of conduct, general regulations and tuition format outlined on back side of this page.
Page 2- Etudes de Ballet & Co. registration form
Etudes de Ballet & Co. code of conduct, general regulations and tuition format:
(1) There are NO REFUNDS for any reason, including but not limited to: bad grades, a loss of interest, injury, moving out-of-town, and transportation problems.
(2) Dress Code adherence for ballet, including hair securely tied back in bun, is expected (except the last week of the session when the dress code is waived.) Level I VIII ballet students are expected to wear black leotards, pink tights, pink ballet slippers and no jewelry. Dance Discovery participants (age 3 6) are expected to wear the required tunic for their class (see attached), white socks with pink ballet slippers. Dance Discovery participants in age 3 & 4/5 classes will also need black patent leather tap shoes.
(3) Students must be on time (unless there are traffic problems beyond the students control) or they will not be allowed to take that class.
(4) Students must wait in lobby until class is called.
(5) Students will not be permitted to leave (i.e. disrupt) class early without prior approval.
(6) No smoking allowed inside any part of the facility.
(7) No food or drink is allowed inside any studio.
(8) All Jazz Team participants are required to attend a minimum of 1 ballet class per week at Etudes de Ballet & Co. and wear required jazz outfits.
(9) Children not attending classes are expected to be supervised at all times.
(10) Screaming/whining children are to be taken outside the building to make it more pleasant for the people inside.
(11) Missed classes must be made up in the present term in the same level or below.
(12) No spots in classes will be held for students until full payment is made.
(13) All children must be potty trained to attend classes.
(14) Class placement may not be discussed during class times. Appointments must be made through the front desk.
(15) All dancers wishing to participate in the RAD exams must attend the required Saturday class in their level in addition of any other days required.
(16) Eligibility for RAD examinations will be determined by the Etudes de Ballet & Co. staff.
Etudes de Ballet & Co. - Information dated 12/18/08
Dance Discovery Dress Code Requirements
3-Year Old Danskin Short Sleeve Leotard
Style 2905 Theatrical Pink
$18 at Etudes / $14 at Danskin
+
Danskin Skirt Style 3318 / Theatrical Pink
$16 at Etudes / $14 at Danskin
4/5 year olds Danskin Tank Leotard
Style 2903 Theatrical Pink
$18 at Etudes / $13.50 at Danskin
+
Danskin Skirt Style 3318 / Theatrical Pink
$16 at Etudes / $14 at Danskin
5/6 year olds Danskin Camisole Leotard
Style 2067 Theatrical pink
$18 at Etudes / $14.50 at Danskin
+
Danskin Skirt Style 3318 / Theatrical Pink
$16 at Etudes / $14 at Danskin
6 year olds Danskin Camisole Leotard
Style 2067 Black
$18 at Etudes / $14.50 at Danskin
+
Danskin Skirt Style 3318 / Black
$16 at Etudes / $14 at Danskin
Leotard sizing Size Height Weight
Toddler 2T-4T 34-40 29-38 lbs.
Small 4-6 40-46 39-50 lbs.
Intermediate 6X-7 46-51 51-62 lbs.
Medium 8-10 51-55 63-78 lbs.
Large 12-14 55-60 79-96 lbs.
3 year olds & 4/5 year olds also need + pink ballet
slippers, white socks, and black patent leather tap shoes. 5/6 year
olds and 6 year olds need pink ballet slippers and white socks.
Leotards & skirt can be obtained at Etudes or at www.danskin.com. Etudes prices include
sales tax. Ballet slippers can be obtained at Etudes, Naples Dance
Supply or at other shoe stores.