Summer Intensive Approval Request

Request approval to participate in the Introductory Summer Intensive by submitting the form below:

Student's Name

First Name

Last Name

Student's Age

Student's Gender

Student's Date of Birth

YYYY

Parent/Guardian Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

If Applicable, detail Student's Dance History (i.e. number of years of ballet, jazz, and tap)

Previous Dance Schools Attended

Select Student T-Shirt Size

THE CENTRAL FLORIDA BALLET, INC. IS A 501(C)(3) NONPROFIT ARTS ORGANIZATION, AND CONTRIBUTIONS
ARE TAX-DEDUCTIBLE UNDER SECTION 170 OF THE INTERNAL REVENUE CODE.