Adult Registration form

Fields marked with a * are required.

2018-2019 Academy Year

January 7 - June 14, 2019


Please select your level/class and session.

(with instructor permission and registration in Monday Adult Ballet)

Student Contact Information


Ballet Virginia International is careful about keeping your personal financial information private and secure. Therefore, someone from our staff will contact you within 24 to 48 hrs during BVI's regular business hours for your credit card information in order to complete the registration process. Please note the registration form received via electronic processing is not complete until payment has been received and secured.

* Late Payment: $10.00 (each late payment)
* Insufficient Funds: $25.00 (returned checks & declined credit cards)

Support BVI

BVI is a 501(c)(3)nonprofit corporation registered with the Virginia Office of Consumer Affairs.


I understand that Ballet Virginia International will not be held responsible for any bodily injuries sustained while on the premises or for loss or damage to any personal items brought on the premises by students or their families this shall include, but not be limited to any and all activities in the dance school, directly or indirectly around the dance school, or in any other place so designated by Ballet Virginia International including performances and outreach activities. In the event of an emergency, I hereby give authority to Ballet Virginia International’s representatives to obtain necessary emergency medical treatment for myself or my child, to hospitalize, to secure medical treatment, and/or to order an injection, anesthesia, or surgery for myself or my child as deemed necessary with the understanding that the family will be notified as soon as possible.

I understand that my insurance coverage for myself or my child will be used in the event medical intervention is needed and that I am responsible for the payment of any/and all medical services.

I understand all reasonable safety precautions will be taken at all times by Ballet Virginia International and its agents during the events and activities. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Ballet Virginia International, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the undersigned.

I understand that in the instruction of dance and in particular, ballet, physical manipulation of a student by the instructor may occur. This physical manipulation will occur only when assisting the student in the proper alignment and execution of dance steps. I hereby authorize the instructors to physically manipulate myself or my child in order to assist in the proper alignment and execution of dance steps.


By initialing below, I hereby irrevocably grant and convey to Ballet Virginia International all rights, titles and interests in and to record my name, image, voice, statements and/or writings including any and all photographic images and video or audio recordings made by Ballet Virginia International. I further irrevocably grant to Ballet Virginia International, its advertisers, customers, agents, successors and assigns, unrestricted rights to use the above mentioned sound, still, or moving images in any medium, including posting on the Internet and World Wide Web, for educational, promotional, advertising, or other purposes without limitation consistent with the mission of the Academy. I agree that all intellectual property rights to the sound, still, or moving images belong to Ballet Virginia. I voluntarily waive the right to inspect or approve such images and waive my right to any royalties, proceeds or other benefits derived from such photographs or recordings.

This release is effective on the date this form is submitted and will remain in effect indefinitely. If individual is less than eighteen (18) years of age, his/her parent or legal guardian must agree below.


All tuition is non-refundable. Refunds will not be made, except in the case of serious illness or injury, verified by a doctor’s certificate. If a student is dismissed from the Academy because of unacceptable behavior, no tuition will be refunded. Ballet Virginia International reserves the right to deny any refund request. Should a tuition refund be issued, the registration fee will not be refunded. If a student wishes to withdraw from the Academy, the Academy Directors must receive, in writing, notification that the student is withdrawing. The parent or guardian is responsible for all tuition payments due up until the point the Academy receives written notification of the withdrawal.