2018 Summer Intensive Registration

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Registration and payment is due by August 4, 2018. Checks can be made out to Central Ohio Youth Ballet, mailed to P.O. Box 735, Newark OH 43055. Please give us a call at 740-366-003 or email at Productionmanager@coyb.org with any questions. 

Dancer Name *
Dancer Name
Please select which session you will attend.
Please enter the dancer's age on August 11.
Dancer Address *
Dancer Address
Dancer Phone #
Dancer Phone #
(if applicable)
Parent/Guardian *
Parent/Guardian
Parent/Guardian Phone *
Parent/Guardian Phone
Parent/Guardian Phone
Parent/Guardian Phone
Parent/Guardian
Parent/Guardian
Parent/Guardian Phone
Parent/Guardian Phone
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone *
Emergency Contact Phone
Please let us know where you currently study dance.
Please describe any other past training experiences.
Please list any pertinent medical or surgical history that may impact your dancer's physical being, movement, and emotional presence during the intensive. Please list any medications - inhalers, EpiPen, insulin, allergies, etc.