Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Classes *

Please check the class(es) you would like to register for.

Monday Ballet (No Test-Juvenile)

Monday Ballet (Juvenile-Senior)

Wednesday Contemporary Modern

Friday Ballet (No Test-Juvenile)

Friday Ballet (Juvenile-Senior)

Liability Release *

By checking this box, I hereby understand that Anne H. Goldberg-Baldwin and the Skating Club of Boston are free from any and all liabilities from injuries, damages, or loss of property. All students participate at their own risk.

Accept

Emergency Contact *

First Name

Last Name

Emergency Contact Phone *

(###)

###

####