Adult Introduction to Ballet Enrollment Application 2025-26

Name

First

Last

Have you enrolled in the Adult Introduction to Ballet program at JMBT before?

Date of Birth

Gender / Pronouns

Optional

Email

Mobile Phone

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Medical & Additional Information

The following information will only be used in the case of a medical emergency.

Allergies

Injury History

Information we can provide to our faculty so they can better serve the needs of your student.

Medications

Other medical conditions or history

Would you be interested in volunteering with José Mateo Ballet Theatre?

Yes
No

If you would like to earn free ballet classes, learn more about our Work Study Program!

Emergency Contact Information

This person will be contacted in case of an emergency situation.

Emergency Contact Name

First

Last

Relationship to You

Mobile Phone

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Diversity 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 / Race

Household Income

What obstacles precent you from attending a José Mateo Ballet Theatre performance?

What is your neighborhood?

How did you hear about José Mateo Ballet Theatre?

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Enrollment Agreement

I,

Student Name

Your Name

in José Mateo Ballet Theatre’s 2025/26 Adult Introduction to Ballet Program.

I understand that payment is due in full at the time of enrollment.

I understand that, should I, for whatever reason, be unable to participate, withdraw from the program, be dismissed with cause, or be absent from the program, payments will not be refunded. Makeup classes are not given unless the student has a valid doctor’s notice for extended absence.

I understand that upon enrollment into the program that mixing and matching different classes/levels, and/or switching classes/levels is prohibited.

I am aware that ballet training and the exercises associated with it can place stresses on the body and can risk physical injury. On behalf of the above named student and myself, I assume this risk and agree that José Mateo Ballet Theatre will not be liable in any way for injuries sustained during participation in the program or related activities.

I grant José Mateo Ballet Theatre the right to make and use photographic and audiovisual documentation of me to be used for philanthropic, promotional, and other mission related purposes. (In no case will your identity be disclosed without written consent.)

I understand that the primary method of communication from José Mateo Ballet Theatre is email through Constant Contact or Gmail in order to send announcements and other pertinent studio information.

If there are any dates you will be absent or late, please list them here.

If there are any conditions that will prevent your full participation in the program, please describe them here:

Signature

Clear Signature

Signature

Today's Date

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Re-enrollment in each class is recommended if the student feels that they are not ready to progress to the next level. However, students are encouraged to only enroll for a maximum of 3 sessions of each level before it is recommended they move up.

Level Selection

Tuition

Tuition Code

Tuition

Price: $250.00

Payment Information

Name on Card

First

Last

Credit Card Information

Card Number

Expiration

/

Security Code

Billing Address

Address Line 1

Address Line 2

City

State

Zip Code

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5 weeks / 10 classes • Ages 18+400 Harvard Street, Cambridge

Medical & Additional Information

Emergency Contact Information

Enrollment Agreement

I,

in José Mateo Ballet Theatre’s 2025/26 Adult Introduction to Ballet Program.

I understand that payment is due in full at the time of enrollment.

I understand that, should I, for whatever reason, be unable to participate, withdraw from the program, be dismissed with cause, or be absent from the program, payments will not be refunded. Makeup classes are not given unless the student has a valid doctor’s notice for extended absence.

I understand that upon enrollment into the program that mixing and matching different classes/levels, and/or switching classes/levels is prohibited.

I grant José Mateo Ballet Theatre the right to make and use photographic and audiovisual documentation of me to be used for philanthropic, promotional, and other mission related purposes. (In no case will your identity be disclosed without written consent.)

I understand that the primary method of communication from José Mateo Ballet Theatre is email through Constant Contact or Gmail in order to send announcements and other pertinent studio information.

Tuition

Payment Information

5 weeks / 10 classes • Ages 18+
400 Harvard Street, Cambridge