Registration form for ballet classes in GCB and all other classes in Triple Threat Studio - please fill in this form, read and sign the release below, then bring to 1st class or mail, with check payable to Gulf Coast Ballet to:
Kathleen Tucker, 2564 Manuel Drive, Lillian, AL 36549


Student’s name____________________Age_____DOB________________

Address_________________________________________Zip___________
City__________________________________________

Phones_______________________________________
E-mail________________________________

Class(es)___________________________________________________________________________

Release Form as required by our insurance company. (Which is strange…because then we should not need to pay them for insurance, right? Oh well, please read and sign anyhow….)
Parents and students recognize that there is a degree of risk in any physical activity and they agree to hold GCB, its instructor, employees, students, members and guests blameless in the event of personal injury, accident, or loss sustained while attending or participating in the school or its activities.

Parent’s signature_________________________
parent’s printed name __________________________


ADDITIONAL SPACE FOR FAMILIES:

 name_____________________age______DOB______________________

Class(es)____________________________________________________________________________

name_____________________age______DOB______________________

Class(es)___________________________________________________________________________

name______________________age______DOB______________________

Class(es)_________________________________________________________________________


Preschool 45 min class - $50 per month
Two Preschool classes - $90
One 1 hr - 1:30 hr dance class - $55
Two 1 hr - 1:30 hr dance classes- $100
Three 1 hr - 1:30 hr dance classes - $145
Four 1 hr - 1:30 hr dance classes - $190
Unlimited classes - $225
Zumba or Pilates, see Andrea Dickey for card

First month's tuition $_______________
Nutcracker performance fee $________(due by Oct 15)
Spring costume $__________________ (due by Dec 15)

Total Enclosed $___________________