SDI Registration

Festival Ballet Providence Summer Dance Intensive Audition Application 2016

Please indicate which program you are auditioning for:
Choose Audition Location and date:

Personal Information

Name: *
Address:
Home Phone:
-
Cell Phone:
-
E-mail:
DOB:
Age:
Sex:
Height:
Weight:
Guardian 1 Name:
Guardian 1 Phone:
-
Guardian 1 E-mail:
Guardian 2 Name:
Guardian 2 Phone:
-
Guardian 2 E-mail:

Medical Information

Have you been under the care of a doctor or physical therapist in the last 6 months? :
Please list any medical conditions or injuries:
Are you currently taking any medications?
If yes, please list any medications taken:
List Allergies:

Training Information

Number of years on pointe (if applicable):
Consecutive years of dance training:


Number of classes per week:

Ballet:
Partnering:
Variations:
Jazz:
Modern:
Other:
Have you previously studied at Festival Ballet Providence?

List all training -including Festival Ballet Providence, and any summer programs:

1.) School/Teacher:
1a.) School Location:
1b.) From / To (years):
1c.) Number of classes per week:

2.) School/Teacher:
2a.) School Location:
2b.) From / To (years):
2c.) Number of classes per week:

3.) School/Teacher:
3a.) School Location:
3b.) From / To (years):
3c.) Number of classes per week:

Your pre-registration fee of $15 dollars is due at the time of audition

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