AUDITION REGISTRATION FORM – QUINTE BALLET SCHOOL OF CANADA

AUDITION REGISTRATION FORM

Student Information

First Name *

Middle Name

Last Name *

Gender

Female

Male

Date of Birth *

Age as of July 1, 2022 *

September 2022 Academic Grade *

Students Cell Phone Number

Students Email Address

Student Contact Information

Father/Guardian's Name (-18)

Mother/Guardian's Name (-18)

Street Address

City

Province/State

Country

Postal Code/ZIP

Email Address *

Home Phone Number

Cell Phone Number *

Ballet Information

Ballet Method Studied

# of Years in Training

A 4x6 photo showing 2nd position tendu facing front must be received prior to the audition.

(.jpg, jpeg, gif)

Last Ballet Exam, if applicable

# of Classes/Week

Current Dance School

Please indicate if you have at least one year of training in the following areas:

Other relevant training - Please Specify

Audition Information or Video Audition Link Submission

Auditon Date & Location *

(City & Date of Audition)

Video Audition Link

(I cannot attend any of the tour audition locations)

Audition Activity and Image Waiver

Each year the Quinte Ballet School of Canada conducts an audition tour for those students seeking acceptance into the Summer Dance Intensive. While precautions are taken to ensure a safe environment, accidents may happen. These accidents result from the nature of the classes and can occur without any fault on either the part of the students, the Quinte Ballet School of Canada, its employees or agents, or the facility where the classes are taking place.

THE CHANCE OF AN ACCIDENT OCCURRING CAN BE REDUCED BY CAREFULLY FOLLOWING INSTRUCTIONS AT ALL TIMES.

The Quinte Ballet School of Canada does not provide any accidental death, disability, dismemberment or medical expenses insurance on behalf of the students participating in the classes and assumes no responsibility for any accident or injury that might be suffered by a student.

ACKNOWLEDGMENT

We have read the above. We understand that by participating in the Quinte Ballet School of Canada master classes and/or audition classes we are assuming the risks associated with doing so.

Liability Release

By checking this box I release QBSC from liability in the event of an accident during the audition and/or master class

I give my consent to QBSC to display or permit publication of photographs or electronic images of this student for use in advertising and media purposes. This may include but is not limited to the QBSC's website and social media sites.

Fee Information

Audition ONLY : $50
Masterclass ONLY : $30

Masterclass and Audition : $60

Please contact the administrative office at info@quinteballetschool.com or 613-962-9274 ext. 21 to make payment arrangements.

* Parent/Legal Guardian signature is not required for students 18 years of age and older.