REGISTRATION:

Email the Lake Erie Academy of Dance with your preference in classes or course of study.
Please fill out this Registration/Agreement Form completely.
Tuitiion arrangements must be made before attendance to classes.
Enrollment is ongoing.
Student's Name
Date Of Birth
(dd.mm.yyyy)
Parent/Guardian
Home Phone
Cell Phone
Email
Address
City
State
Zip Code
Please specify any physical or mental impairments :
Emergency Contact:  
Name
Phone
 
LEB Guild / Friends of the Ballet - Please indicate your area of interest in support or service to LEB.













Yearly Donation $
Other

Tuition Payment Agreement

I agree to pay the LEB for the dance instruction of the above student per the published tuition rates for the student’s period of study, unless I am applying for 1) Financial Sid (sliding scale tuition rates) or 2) Scholarship. I understand that I can make a payment by check, payable to “Lake Erie Ballet”, MasterCard, Visa, or cash, and that there will be a $20 charge for returned checks and declined credit cards.

I understand that payment of tuition entitles students to take all the scheduled classes at their level, and that no refunds are given for classes missed because of illness or vacation.

I understand that tuition fees are due on the first of each month or the first of each semester; that if installment payments have not been received by the 10th day of the month or the 10th day from the beginning of a semester, a finance charge of 5% per month will be assessed as of the due date.

*Note: If you are applying for financial aid (sliding scale arrangements) or scholarship, it is your responsibility to provide the LEB office with the proper forms in a timely manner. Please see scholarship information below and initial the line provided.

Publicity Release

I hereby authorize LEB to record the student’s picture on photographs, films, and tapes, and to edit these recordings at its discretion. LEB is permitted to use these materials for publicity, advertising and sales promotion. I acknowledge that no promises of compensation were made by LEB for such use.

Medical Release

In the event I cannot be reached, I hereby give my permission to any LEB faculty or staff to authorize any emergency care that may be required by the above student during participation in classes, performances, or any related LEB events. This authorization extends throughout the current academic season. I understand that I am responsible for any and all charges as a result of such care or medical treatment.

I have read, understand, and agree to the Tuition Agreement, Publicity Release, and Medical Release. I have completed the Registration Form in its entirety and understand that the registration form must be electronically submitted or mailed to the Lake Erie Ballet studio included with the first month tuition, or term payment, and that payment is due at time of registration.

Scholarship Deadlines:

August 28 for Term I
January 15 for Term II and
May 25 for Term III

Financial Assistance (sliding scale tuition rates), Work/Study Exchange and/or Scholarships Agreements are assessed each Term. Once arrangements have been made, agreements will be honored for the duration of the season during which the agreement is made.

I would like to apply for Financial assistance or Scholarship for my child/children. I understand that this aid is limited each season and that I and/or my child may have to perform duties in and/or outside of the studio. I understand that I can only be considered for finacial assistance (sliding scale tuition rates) or scholarship after an application and all required attachments are submitted.

Clicking the "submit" button indicates I have read and understand the tuition policies and procedures outlined by the Lake Erie Ballet provided to me.

Preferred method of payment:



Name of Parent or Guardian:
 

 

 

 

 

 
 

Lake Erie Ballet • 701 Holland • Erie PA 16501 • 814-871-4356 • Email  •  Season

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