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Child's Name * First Last
Age & DOB *
Parent or Guardian * First Last
Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact Information: Email, Daytime, Evening and Cell Phones. *
Medical Concerns & Allergies *
Person(s) authorized to Pick up student *
Kinderballet (Ages 3-5)
Monday 3:45-4:45 PM
Tuesday 3:45-4:45 PM
Wednesday 2:45-3:45 Pm - Closed

Pre-Ballet (Ages 4 1/2-5)
Wednesday 3:45-4:45 PM

Ballet I (Ages 5-7)
Tuesday 4:45- 5:45 PM
Wednesday 4:45- 5:45 PM (Beginners Preferred Class)

Advanced Ballet I (Ages 6-8)
Thursday 3:45-4:45 PM

Ballet II (Ages 8-12)
Monday 4:45-5:45 PM
Thursday 4:45-5:45 PM
*
Monday KB 3:45-4:45 PM Tuesday KB 3:45-4:45 PM Wednesday Pre-B 3:45-4:45 PM Tuesday BI 4:45-5:45 PM Wednesday BI 4:45- 5:45 PM (Beginners Preferred Class) Thursday Advanced BI 3:45-4:45 PM Monday BII 4:45-5:45 PM Thursday BII 4:45-5:45 PM
May we use your child's picture on the MLYNA website? *
YES NO

As you probably noticed when you logged on to Register, we show class pictures, recital pictures and camp pictures to help show what MLYNA ballet is all about. Please indicate your preference.
Form of Payment *
Paypal (Registration Page) Check (Payable to MLYNA, PO BOX 3081, Alexandria, VA 22302)

Monthly payments are due first week of each month to avoid $5 LATE Fee. Tuition is NOT refundable unless MLYNA cancels a class for the term. Missed classes can be made up. Please call Miss Lynne schedule make-up class.
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