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 End Section 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 * End Section 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 the School at firstname.lastname@example.org (.jpg, jpeg, gif) End Section I am enrolling in: Please check all that apply: * Professional Training Program (audition required) Open Training Program (no audition required) 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: End Section Fee Information Please contact the administrative office at 613-962-9274 ext 21 or email@example.com to make payment arrangements. End Section If you are human, leave this field blank.