Adult Introduction to Ballet Enrollment Application 2025-265 weeks / 10 classes • Ages 18+400 Harvard Street, CambridgeClass Schedule & Calendar 2025-26Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student Information – Step 1 of 5Name *FirstLastHave you enrolled in the Adult Introduction to Ballet program at JMBT before? *— Select Choice —YesNoDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender / PronounsPrefer not to sayShe/HerHe/HimThey/ThemOptionalEmail *Mobile Phone *Home Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMedical & Additional InformationThe 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?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.Emergency Contact Name *FirstLastRelationship to You *Mobile Phone *NextSave and Resume LaterDiversity 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 *Prefer not to sayAsianBlack or African AmericanHispanic or LatinoNative American or Alaska NativeNative Hawaiian or Other Pacific IslanderWhiteOtherHousehold Income *— Select Choice —Prefer 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 precent 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? *— Select Choice —ReferralSocial MediaSearch EngineWord of MouthAdvertisementEmail NewsletterEventWebsiteBlog PostOtherWho referred you? *PreviousNextSave and Resume LaterEnrollment AgreementI,Student Name *Your Namein 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 SignatureSignatureToday's Date *PreviousNextSave and Resume LaterRe-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 *Level ILevel IILevel I Class Time *Monday & Wednesday | 6:30-8:00PMTuesday & Thursday | 6:30-8:00PMLevel II Class Time *Monday & Wednesday | 6:30-8:00PMTuesday & Thursday | 6:30-8:00PMLevel I is entirely full for Fall I !!Level II Session Dates *Fall I | September 8 – October 10Fall II | October 13 – November 14Winter I | November 17 – December 19^Winter II | January 5– February 6Winter III | February 9 – March 13Level I is entirely full for Fall II !!Level I Session Dates *Fall I | September 8 – October 10Fall II | October 13 – November 14Winter I | November 17 – December 19^Winter II | January 5 – February 6Winter III | February 9 – March 13^Makeup class for Thursday, November 27 (Thanksgiving) will be Friday, November 21TuitionTuition CodeTuitionPrice: $250.00Tuition (WSWS) *Price: $0.00Tuition (AI25SPTT) *Price: $230.00Tuition (Yuanyuan Ma) *Price: $100.00Credits from Summer Session IIIPayment InformationName on Card *FirstLastCredit Card Information *Card NumberMM123456789101112Expiration/YY2526272829303132333435Security CodeBilling Address *Address Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeNextSave and Resume LaterUpdating 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.PreviousSubmitSave and Resume LaterYour form entry has been saved and a unique link has been created which you can access to resume this form.Enter your email address to receive the link via email. Alternately, you can copy and save the link below.Please note, this link should not be shared and will expire in 30 days, afterwards your form entry will be deleted. Copy Link Email * Send Link