Adult Intro Fall I 2026 Registration Form: Level 2, Monday/Wednesday Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form. – Step 1 of 4Name *FirstLastHave you enrolled in the Adult Introduction to Ballet program at JMBT before? *YesNoDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender/PronounsPrefer not to sayShe/HerHe/HimThey/ThemOptional Email *Mobile Phone *Home Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMedical and Additional InformationThe following information will only be used in the case of a medical emergency.Allergies *Injury History *Medications *Other medical conditions or history *Would you be interested in volunteering with José Mateo Ballet Theatre?YesNoIf you would like to earn free ballet classes, learn more about our Work Study Program! Emergency Contact InformationThis person will be contacted in case of an emergency situation.Name *FirstLastRelationship to You *Mobile Phone *NextDiversity and inclusion are at the core of José Mateo Ballet Theatre’s mission and commitment to the community. Gathering the information listed below allows us to improve the customer service that we give to all families. In addition, this information will further our diversity and inclusion efforts and assist in applying for grants and funding. This information will be kept anonymous and only be used to meet the needs of the families we serve. Ethnicity / RacePrefer not to sayAsianBlack or African AmericanHispanic or LatinoNative American or Alaska NativeNative Hawaiian or Other Pacific IslanderWhiteOtherHousehold IncomePrefer not to sayLess than $25,000$25,000 – $49,999$50,000 – $74,999$75,000 – $99,999$100,000 – $149,999$150,000 – $199,999$200,000 – $249,999$250,000 or moreWhat obstacles prevent you from attending a José Mateo Ballet Theatre performance?Ticket CostChildcareLocation of the theatreNot enough timeNot interestedOtherNone – I already attend!What is your neighborhood?How did you hear about José Mateo Ballet Theatre?ReferralSocial MediaSearch EngineWord of MouthAdvertisementEmail NewsletterEventWebsiteBlog PostOtherNextFall I Level I M/W Tuition $250Price: $250.00Payment InformationName on Card *FirstLastCredit Card Information *Card NumberMM123456789101112Expiration/YY2627282930313233343536Security CodePreviousNext Theatre hear Tuition Updating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit
