Pittsburgh Youth Ballet Company & School
Pre-Intensive Summer Program June 22-26 and August 17-21
Thank you for your interest in the Pittsburgh Youth Ballet Company’s Summer Pre-Intensive Program. We hope you will be able to take advantage of this exciting opportunity to study with other talented dancers.
The Summer Pre-Intensive Program will be held June 22-26 and August 17-21, and is open to all Beginner to Intermediate dancers. The students in this Pre-Intensive program do have the option of attending on a weekly basis if space allows. We keep our enrollment to around 15 students per class so that each dancer will have individual attention with a strong emphasis on detail, and encouraged to achieve artistry and clean strong technique.
Our summer faculty includes some of the most distinguished teachers and choreographers from around the world, including Jean Gedeon, Dana Arey, Kathy Stark, Erin Halloran, Christine Rennie, Alan Obuzor, and Patrick Hinson along with other internationally renowned teachers such as NYC Ballet Alumni Garielle Whittle.
Please note enrollment is limited and classes are filled in the order in which the completed forms and deposits are received with priority given to those dancers registering for both weeks. Please complete return all forms with payment to Pittsburgh Youth Ballet Company and School, 210 Valleybrook Road, Pittsburgh, PA 15317. Forms can also be emailed or faxed.
If we can help you in any way please call our office at (724) 969.6000, or FAX (724)969.6900, or Email at . Lastly, we invite to learn more about us by visiting our web site at www.pybco.com as it is under construction and updated almost weekly. We look forward to hearing from you.
Dual Week Package:
Pre-Intensive Two-Week Summer Program Tuition
Ages 6-10 (½ day): 2 weeks $500. June 22-26 and August 17-21
Weekly Enrollment Tuition Options:
Pre-Intensive Summer Camp
Ages 6-10 (½ day): $275.00 weekly June 22-26 or August 17-21
Pre-Intensive
$35. Application fee (non-refundable) OR $40 Family Registration
$75 Tuition deposit, per week, which will be applied to total tuition. (non-refundable)
.
*Priority registration to those students attending both weeks. Enrollment is limited. Classes are filled on a first-come basis.
Make checks payable to PYBC, 210 Valley Brook Road, McMurray, PA 15317.
Payments
By June 1st Half of total tuition due
By July 1st Remaining balance of tuition and fees due
Please register early. You will be notified within two weeks by Email or regular mail from the receipt of registration with payment.
Name______
Email Address ______
Zip ______Phone ______
Address______
Attendance Information
Please indicate the weeks in which you will be attending:
Pre-Intensive:
Week 1______
Week 2______
Pittsburgh Youth Ballet Company & School
Pre-Intensive Summer Application Form 2015
St Petersburg Center · 210 Valley Brook Road · McMurray, PA, 15317
Phone: 724. 969.6000 · FAX 724. 969.6900
Email - or . • website- www.pybco.org
Name ______
(Last) (First) (Nickname)
Address______City ______
State ______Zip ______Phone ______Email: ______
Mother’s Name ______Work Phone # ______
Mother’s cell Phone ______Student’s cell______
Place of Employment Occupation ______
Father’s Name ______Work Phone/ Cell ______
Place of Employment ______Occupation______
Birth Date ______Height ______Shirt size______Emergency Phone(_____)______
Former & Current Ballet School______
Number of Years Attended ______
Teachers______
By signing below, I understand that full tuition is due regardless of the number of classes attended. There will be no refunds of tuition due to schedule conflicts, vacations, etc. All deposits are non-refundable.
Parent Signature ______
As payment we accept VISA / MasterCard /DiscoverCard -Checks should be made payable to PYBC School
Dates Attending______
Summer Tuition Total ______
Summer Weekly deposit______
$35 Application Fee ______
($40 Family Application fee - non refundable)
(For out of town students only)
Total Enclosed/ Deposit______
Pittsburgh Youth Ballet Co. Medical Release Form
Dear Parents:
Please read the following carefully: Your child will not be permitted to attend classes until this release is received by PYBC. “I am aware that ballet dancing and the gymnastic exercise associated with it place unusual stress on the body and carry with them the risk of physical injury. On behalf of my child and myself, I assume the risk and agree that the Pittsburgh Youth Ballet School, Pittsburgh Youth Ballet Company, Board of Directors, Faculty, and any of the chaperones and agents shall not be liable in any way for any injuries sustained or loss of property during attendance at the school or any of its related functions.” My child has permission to be treated for emergency medical care.
*We need a photocopy of your insurance card, both sides please.
______
Signature of Parent or Guardian Witnessed by
______
Medical Insurance Agreement Number
______
Family Physician & Phone Number Allergies & prescriptions
Pittsburgh Youth Ballet Media Release Form
I give my permission for photographs or television footage that includes my child to be used for promotional purposes on television, or in newspapers, magazine or any other media.
______
Signature of Parent or Guardian Date
“Celebrating 25 Years” Spring Byham Theater - NYCB’s Daniel Ulbricht
Contact us at:
Email ∙ Web Site: www.pybco.com
St. Petersburg Center 210 Valley Brook Road, McMurray, PA, 15317
Phone: 724. 969.6000 · FAX 724. 969.9600