Audition Registration

Professional Division Summer 2017 Audition Registration

Student Name *

First

Last

Age *

Date of Birth *

Parent/Guardian Name 1 *

First

Last

Parent/Guardian Name 2 *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Home Phone Number *

Cell Number *

Email *

List all Medical Conditions including current and past injuries *

Previous Dance Experience *

Number of Years on Pointe *

Submit

Founding Artistic Directors: Svetlana Kravtsova and Vadim Pijicov

M-F: 3pm-8pm
Sat: 10am-2pm

443-393-1197

9147 Red Branch Rd, Ste D,
Columbia, Maryland 21045

officerbam@gmail.com - Office
russballet@gmail.com - Director*
*for business and emergency use only