Summer Dance Intensive Registration Student Information First Name * Middle Name Last Name * Gender * Female Male Date of Birth * Age as of July 1, 2021 * September 2021 Academic Grade * Student Cell Phone Number Student Email Address Parent Information Mother/Guardian's Name (-18) Father/Guardian's Name (-18) Street Address * City * Province/State * Country * Postal Code/ZIP * Email Address * Home Phone Number Cell Phone Number * School Information Current Dance School Method/Level Studied & Last Exam Passed A 4x6 photo showing 2nd position tendu facing front must be uploaded here, or emailed to email@example.com (.jpg, jpeg, gif) Residence or Day: Please indicate if student requires residence or will be coming as a day student: * Residential Student Day Student Have you attended our Summer Dance Intensive previously? If so, when and which program? How did you hear about the Quinte Ballet School of Canada: * Website Social Media Magazine Current dance school Word of mouth Returning student Other. Please specify:Other. Please specify: Fee Information Please contact the administrative office at 613-962-9274 ext 21 or firstname.lastname@example.org to make payment arrangements.