Teenager’s Introduction to Ballet Enrollment Application 2025-2610 weeks / 10 classes • Ages 11-18400 Harvard Street, CambridgePlease enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Student Information – Step 1 of 6Student Name *FirstLastPreferred Name *Have you enrolled in the Teenager's Introduction to Ballet program at JMBT before? *— Select Choice —YesNoDate of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender / PronounsPrefer not to sayShe/HerHe/HimThey/ThemOptionalGrade (2025-2026 Academic Year) *— Select Choice —6th Grade7th Grade8th Grade9th Grade (Freshman)10th Grade (Sophomore)11th Grade (Junior)12th Grade (Senior)School *Student EmailPlease fill out if you would like your student to receive information about the Teen Intro Program. Payment information will not be shared with your student.Student PhoneIf applicableHome Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDance School *If you have no prior dance experience, please write N/A.Medical & 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 *Please include here any additional members of the family or household (e.g., siblings and their ages) that may be helpful to the teacher’s understanding of the student’s family or social context: *Please list any activities, hobbies, or other strong interests aside from dance that are a regular part of the student's extracurricular experience: *Language(s) spoken at home (other than English): *NextSave and Resume LaterPrimary Parent / Guardian Name *FirstLastEmail *Mobile Phone *Employer *This information is confidential and may be used to assist applying for grants and funding.Work PhoneIf applicableAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAdd Second Parent / GuardianAdd Second Parent / GuardianSecond Parent / Guardian NameFirstLastEmailMobile PhoneEmployerThis information is confidential and may be used to assist applying for grants and funding.Work PhoneIf applicableAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeAdd Third Parent / GuardianAdd Third Parent / GuardianThird Parent / Guardian NameFirstLastEmailMobile PhoneEmployerThis information is confidential and may be used to assist applying for grants and funding.Work PhoneIf applicableAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmergency Contact InformationThe emergency contact person should not be any of the parent / guardians listed above. This person will be contacted in case the parent / guardians listed above are not available or responsive in an emergency situation.Emergency Contact Name *FirstLastRelationship *Mobile Phone *PreviousNextSave 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 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? *— Select Choice —ReferralSocial MediaSearch EngineWord of MouthAdvertisementEmail NewsletterEventWebsiteBlog PostOtherWho referred you? *PreviousNextSave and Resume LaterI hereby enrollStudent Name *Student Namein José Mateo Ballet Theatre’s Teenager’s Introduction to Ballet course.I understand that payment is due in full at the time of enrollment.I understand that, should the student, 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.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 my child to be used for philanthropic, promotional, and other mission related purposes. In no case will the child’s identity be disclosed without written parental 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.Parent / Guardian Signature * Clear SignatureParent / Guardian SignatureToday's Date *José Mateo Ballet Theatre Teenager’s Introduction to Ballet Students must:• Remain committed to attending the full program or the portion of the program for which they have enrolled.• Comply with all rules and regulations of José Mateo Ballet Theatre including, but not limited to, dress code, punctuality, and class etiquette.• Attend and be on time to all scheduled classes. Students may not be late to class more than two times or have more than one unexcused absence during the course of the program.• Participate in all scheduled classes, activities, and other organizational programs.• Seek and receive permission from artistic staff before enrolling in additional dance classes or accepting a performance engagement.Failure to comply with these policies may affect a student’s eligibility for performance opportunities and financial aid. We understand that some circumstances may make these policies difficult. We ask that you communicate honestly with us about any challenges that may prevent your child from participating fully in the program. We will do our very best to work with you to help your child to get the most out of the program, and we are thrilled to have them dance with us.If there are any conditions that will prevent your child’s full participation in the program, please describe them here: *If there are any dates your child will be absent or late, please list them here along with the reason for the absence/lateness, please list them here: *Parent / Guardian Signature * Clear SignatureParent / Guardian SignatureToday'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 into the Young Dancers Program.Are you applying for a need-based scholarship? *— Select Choice —NoYesDid you receive a need-based scholarship (financial aid) for the Young Dancers Program 2024-25? *— Select Choice —YesNoSession *SESSION I | September 27 – December 6`SESSION II | January 10 – March 21*SESSION III | March 28 – June 13^`No Class on November 29, 2025 (Thanksgiving) *No Class on February 21, 2026 ^No Class on April 4, 2026 (Easter) and April 25, 2026Tuition CodeTuitionPrice: $250.00Tuition (BOWDOIN24)Price: $0.00Need-Based Scholarship Application MaterialsPlease upload a digital copy (e.g., scan, image, pdf) of your most recent tax filing below. This must include the IRS Form 1040 showing the student listed as a dependent and showing your Adjusted Gross Income.If you do not file taxes, alternative accepted documents include: Proof of social security, Food stamps, Health connector, Letter from your student’s school stating financial need. If you do not have any of the above documents or have questions about income documentation, please email registration@ballettheatre.org.Tax Files * Drag & Drop Files, Choose Files to Upload You can upload up to 10 files.Statement of Financial Need *Statement of student's interest in the study of dance *Statement of the family's willingness to support this interest *Statement of commitment to full participation in the program and the eligibility requirements/stipulations outlined in the Need-Based Scholarship section of the Teenager's Introduction to Ballet page *Payment 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 CodePreviousNextSave 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.PreviousPhoneSubmitSave 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
