Registration

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Welcome to Campaneria Ballet School! Please complete the following registration form.

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Referral Information
Family Information
Where do you live?
Additional Info
Contact #1
How Can We Contact You?
Portal Access (your email is your login)
(Emails are kept confidential)
Contact #2
How can we contact you?
(Emails are kept confidential)
Student #1
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Additional Info

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Required Policies and Agreements
• As the enrolled participant and/or the parent/guardian of the participant, I agree and understand that dance/fitness/ training is a potentially hazardous activity. I recognize that there are risks inherent in dance training including but not limited to serious physical injury. The participant hereby agrees to participate in activities of the Campaneria Ballet School (CBS) and hereby agrees to indemnify and hold harmless CBS, its instructors, officers, directors, agents and employees against any liability resulting from any injury that may occur to the participant while participating in activities of the CBS. The participant also agrees to indemnify CBS for any damages incurred arising from any claims, demand, action or course of action by the participant. The participant authorizes any representative of CBS to have the participant treated in any medical emergency during their participation in activities of the CBS. Further, the participant and/or parent/guardian agree to pay all costs associated with medical care and transportation for the participant.
• Any medical/health problems, of which the staff must be aware, are disclosed in the Important Health Information section of the Registration Form.

• If you post videos of class or rehearsals, don't post any choreography in its entirety; CBS and its teachers own the copyright to all choreography taught at the school. Respect the law, including those laws governing defamation, discrimination, harassment, and copyright and fair use.
• Live-streaming during class or rehearsals is not allowed.
• Pictures during class or rehearsals are not allowed.

Should you have any questions, please do not hesitate to contact the studio directly, via phone (919-651-4650) or studio email (campaneriaballetschool@gmail.com). Our website and parent portal is kept up-to-date and should help you find the answer to most of your questions (www.campaneriaballetschool.com).
*****Please avoid contacting the faculty/directors directly via their personal cell phones, text messages or Facebook.

All students are expected to participate in the recital in May.
Performance experience is considered an integral part of a student's dance training. Known conflicts with recital performance or preparation must be
communicated in writing to the instructor prior to November as this will affect costuming and choreography. All accounts will be assessed a non-refundable recital fee per class in November and January.


• Campaneria Ballet School promotes a professional environment. Therefore, it is the expectation of our school that students treat the teachers, staff, and fellow students with respect.
• Campaneria Ballet School upholds a zero tolerance policy for the use of profanity, disrespectful language, or bullying. Such behavior will subject a student to removal from class and/or the school.
• In order to sustain a positive environment that fosters respect and kindness, we ask that students or parents with concerns schedule an appointment with the Artistic Director, Instructor, or Office Manager.


• Students are expected to arrive to class on time. Kindly call the office if your dancer will be late or absent so the instructor can be informed.
• Students who are more than 15 minutes late to class will be admitted at the instructor's discretion only.
• Parents and students are responsible for knowing class times and scheduled rehearsals. Please note that there are extra
mandatory rehearsals and possible schedule changes before company and school performances.
• Excellent attendance is expected as frequent absences will affect a student's progress, class placement, casting and
performances. In addition, we want our students to learn the value of commitment and time management.

In case of a medical emergency, I hereby give permission to Campaneria Ballet School, Staff, Trainers and Volunteers to order treatment for my child, including any necessary medical treatment and x-rays. I also hereby give permission to Campaneria Ballet School, Staff and Volunteers to disclose the information contained on this form to medical personnel.

I understand that an attempt will be made to reach me by phone after calling for Emergency Medical Services, and again when a diagnosis is completed. I agree to pay all medical, hospital, or other expenses, which my child may incur as a result of such treatment. Campaneria Ballet School, also does not provide any medical or other insurance protection or benefits for those who participate in the Campaneria Ballet School programs.

• As the enrolled participant and/or the parent/guardian of the enrolled participant, I authorize Campaneria Ballet School and/or its representative, agent or employee to photograph and/or videotape and use any photograph/likeness of me or my minor child for any purpose, including publicity, choreographic archives, promotional materials and/or any other reason deemed appropriate by the School Director.
• Photography and/or videography from the wings of the stage, or dressing rooms for any and all rehearsals and for any and all performances by Campaneria Ballet School, Campaneria Ballet Company, and Campaneria Dance Ensemble is not allowed.

• Be courteous and respectful at all times.
• Show respect for the property of others by refraining from handling the belongings of others without permission.
• Keep food and drinks, other than water, out of the CBS studios.
• Arrive to class on time and prepared.
• Follow appropriate dress code for all classes and rehearsals.
Jazz, Modern, Contemporary, Acro, and Hip Hop students should wear long pants or tights so that floors are protected from oils and sweat.
• Dispose of trash in the trashcans. Empty liquids into the sink in the kitchen area before putting the containers in the trashcans.
• Refrain from all running and shouting inside of the dance school.
• CBS Staff only may enter the office area unless permission is given otherwise.
• Wear dance shoes or remove street shoes before entering the studio.
• Wear dance shoes indoors only.
• Store dance bags and other items in the cubbies provided.
• Permission to video or photograph class rehearsals/practice time will not be given. In the event that dancers require a video of class time/rehearsals, a Staff member will take the video and share it with the parents via the portal.
• Use respectful and acceptable language at all times.
• Wait inside of the building for your ride to arrive.
• Dancers should leave all iPods, cell phones and other electronics in their personal belongings and in storage units provided. Cell phones are not allowed in class and will be removed from the student until the end of class, and the guardian will be notified.
• Dancers are to leave bags, coats, and other personal belongings outside of the studios. Cubbies and Dressing Rooms are available for storage.
• No food or drink is permitted within the studios except water.

• Make-up classes are offered within 60 days of the missed class and cannot be used instead of a tuition payment for the next month or trimester. Make-up classes are not permitted during Parent Observation Periods.
• Please notify the school prior to taking any make-up class.
• Please note that tuition payments are due regardless of absences due to vacations, illness, or other circumstances that
interfere with attendance.

• Withdrawal from Campaneria Ballet School or dropping a class MUST BE DONE IN WRITING by submitting a withdrawal form to the school office by the 5th of the month and will be effective the following month. One month's (30 day) notice is required.
• If this criterion is not met, the account holder will be held financially liable for payment until the school office receives a withdrawal form.
• Withdrawal from or re-enrollment into a class due to prolonged illness or injury must be verified with a physician's written consent.
• Withdrawal and enrollment may be done via the portal by contacting school administration.

I agree that the student name which I have entered into Jackrabbit (aka my parent portal), is true and correct. I agree that the student's name is spelled correctly and may be printed in this same manner on any and all recital / performance playbills or cast list.

I agree to abide by the dress code provided by Campaneria Ballet School.
• Hair: Dancers are to have their hair pulled back and off their face into a pony tail for Jazz, Contemporary, and Tap. Ballet classes will require hair pulled back and into a bun.
• No Crop tops
• No booty shorts
• No baggy pants / shirts / sweatshirts. Ballet warm-up attire is left to the discretion of the instructor.
I understand and acknowledge, that my child will be given appropriate clothes to wear and charged a $15 fee each time clothing has to be provided to the student. The teacher and/or faculty reserves the right to not allow your child into class, and a parent or guardian will be called to pick up the child. Tuition reimbursement and/or makeups will not be allowed due to failure to adhere to the dress code.

• All tuition will be posted for payment on the 1st of the month.
• Tuition is subject to change.
• A $15 late fee will be assessed to each student's account if payments are not received within five (5) days of the scheduled due date.
• A $15 charge for each declined credit card transition.
• Students with delinquent accounts of one month will be admitted to class after their account balance is paid in full or arrangements are made with a senior representative of Campaneria Ballet School.
• Tuition, deposits, and registration fees are nonrefundable.

The debit/credit card details provided by you for use of C&H Financial and/or Jackrabbit will be correct and accurate and you shall not use a debit/credit card, which is not lawfully owned by you. You further agree and undertake to provide correct and valid debit/credit card details. You may make your payments to Campaneria Ballet School by using a Debit/Credit Card or through using your Online Banking Account. When You initiate a payment transaction and/or issue a online payment Instruction and provide Your Card / Bank details:
1. You warrant that You are fully and lawfully entitled to use such Credit / Debit Card, Bank Account for such transactions,
2. You are responsible to ensure that the Card, Bank Account details provided by You are accurate,
3. You are authorizing the debit to the nominated Card, Bank account for the settlement of payment of services selected by you along with the Applicable charges and taxes.
You are responsible to ensure that sufficient credit is available on your nominated Card, Bank Account at the time of making the payment selected by you inclusive of the applicable taxes.

I Agree to All of the Above
Questions or Concerns
Payment Information
Account Information
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