Print this form. Mail your
completed form to Birmingham Ballet.
2003-2004 School Year Registration Form
 | ||
I have read and understood the information
printed above and agree to abide by the policies of BBA.
I hereby give permission for Birmingham Ballet and/or BBA
to use photographs/videos of my child’s likeness in
BB/BBA sponsored publications and for promotional purposes.
________________________
__________
(parent or guardian’s signature)
(Date)
I have enclosed:
o $40 Registration Fee and Tuition Payment #1
o $40 Registration Fee.
I will send Tuition
Payment # 1 prior to August1.
Student’s
Name__________________________________________ Age______
Birthdate ________
Class(es) of your
choice___________________________________________________________________________
Address_____________________________________________________
Zipcode______________
Home Phone # _______________
Academic School __________________________Grade________
Parent Information : Mother’s
Name___________________ Father’s
Name_____________________
Employer________________________
Employer_________________________
Work Phone #____________________ Work Phone #
_____________________
Cell Phone_______________________ Cell
Phone_________________________
e-mail___________________________
e-mail_____________________________
Return your completed Registration Form
with your payment to:
Birmingham Ballet Academy, 2198
Columbiana Road, Suite 100, Birmingham, Al 35216.