Registration | Affirmation Ballet

Affirmation Ballet Company & Performing Arts Centre

Enrollment / Application for Session 1

Academic year September 21, 2026 - June 7, 2027 (34 weeks)

For families with multiple students, please list each child's name and birth dates below. Complete only one form unless other details differ. To ensure that we have the most accurate information for our records, please complete all sections below. All details provided will remain confidential and used solely for the purposes of class placement, school announcements, and emergency contact if needed. If any of this information changes during the year please contact us so it can be updated.

Full Name (Student 1)

Grade in School

Date of Birth

Full Name (Student 2)

Grade in School

DOB

Full Name (Student 3)

Grade in School

DOB

Full Name (Student 4)

Grade in School

DOB

ADULT Student only: Place of Employment

Mother's Name

Mother's Phone (Cell)

Father's Name

Father's Phone (Cell)

Student's Phone if Applicable(Cell)

Mailing Address

City

Zip Code

Email (to be used for school communication ONLY)

LOCAL Emergency Contact (OTHER than Parent)

Emergency Contact Phone (Cell)

Relationship

Emergency Contact Mailing Address

City

Zip Code

Person(s) responsible for tuition if other than parents/self

Mailing Address

City

Zip Code

Contact Phone (Cell)

Any medications or physical limitations to be aware of: (please explain)

Please list ALL classes applying for enrollment in: PER STUDENT

NEW students ONLY - Complete information below

If applicable, list prior and/or present training. Please include disciplines, ballet, modern, jazz, tap, etc., years of study, location, and syllabus.

Long answer

ALL APPLICANT'S:

I / We have read, understand, and therefore accept and will adhere to ALL the requirements and responsibilities set forth in the school policy of Affirmation Ballet Company and Performing Arts Centre regarding this academic year of 2026/2027, private lessons / summer session.

1st Parent Signature

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2nd Parent Signature

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Date

STUDENT Signature (students 10 - adult)

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Date

Financial Agreement:

I / We understand and accept our responsibility for timely payment of tuition for the duration of the academic year. Tuition paid monthly to be received in the school office on or before the first. Please allow five to seven days if you make payment by mail. Payment received after the seventh of the month will be subject to a late fee of $15.00 and must be included in the payment due. Any accumulated late fees and any other unpaid account balances must be paid by MAY 1, 2027.

Regarding private lessons - Tuition is paid in advance. Account set up at time of enrollment.

Parent’s / adult student signature or person(s) responsible for tuition.

Signature

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Signature

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Date

Upon completion, please submit the registration fee AND applicable 1st tuition payment. Checks made Payable to AB_PAC, Inc.

Affirmation Ballet Co & Performing Arts, Inc.

5825 66th Street N. Suite 215

Pinellas Park, FL 33709

https://www.affirmationperformingarts.com/makepayment