Online Registration | Ballet & Beyond

Registration Form:

Student First Name

Student Date of Birth

Student 2 First Name

Student 2 Date of Birth

Student Last Name

Student Age

Student 2 Last Name

Student 2 Age

Parent 1 First Name

Parent 2 First Name

Parent 1 Last Name

Parent 2 Last Name

Phone 1

Phone 2

Email 1

Email 2

Full Address

Please List Any Allergies or Health Problems That Your Child Might Have, That We Should Know About:

I authorize Ballet & Beyond to photograph and or video my child to be use for advertizing purposes andor to be put on the internet. (If you agree, check the box and sign your name bellow)

Sign to confirm that you read and agree to the statement above:

RELEASE AND WAIVER OF LIABILITY AND INDEMNITY 2023-2024: I (the guardian) agree that the student’s use of Karen Hirst Kennedy / Ballet & Beyond facilities, equipment, services, or premises may involve risk of injury to persons, including those injuries described below. Student and Parent assume full responsibility. Parent and Student hereby release Karen Hirst Kennedy / Ballet & Beyond, its employees, and agents harmless from all liability for any loss or damage, for injury to Student, whether caused by the active or passive negligence of Karen Hirst Kennedy / Ballet & Beyond. Student agrees to indemnify Karen Hirst Kennedy / Ballet & Beyond for any loss, liability, damage it may incur due to the presence of the Student in, upon or about Karen Hirst Kennedy / Ballet & Beyond premises, facilities, services or equipment. Parent represents that (a) the Student is in good physical condition and has no disability, illness, or other condition that could prevent Student from exercising without injury or impairment of health, and (b) that Student has consulted a physician concerning an exercise program that will not risk injury to student or impairment of Student’s health. The risk of injury may include injuries arising in participation by Student in supervised or unsupervised activities at the school; injuries and medical disorders arising from exercising at the premises such as sprains, broken bones, torn ligaments, torn muscles, heart attacks and strokes and accidental injuries occurring anywhere at the School. Parent agrees that the foregoing release, waiver and indemnity agreement is intended to be as broad as is permitted by laws of the State of Florida and that if any portion is held invalid, it is agreed that the balance shall continue in full force and effect. (By checking this box, you are confirming that you read and agree to the terms outlined in the "Release and Waiver of Liability and Indemnity 2023-2024" listed above.)

Sign to confirm that you read and agree to the terms outlined in the "Release and Waiver of Liability and Indemnity 2023-2024" listed above:

Date Signed

Select an item ($)

Non-Refundable Registration Fee (+ Online Payment Fee) - $68

Thank you for registering! Please head to the "Online Payment" page to pay for your leotard, show, and monthly class fees.

Website is still in development. If you experience any issues, please feel free to contact us with any questions you may have.

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