Student First Name*
Student Last Name*
Please select program(s)*
June 22-26 Camp
June 29-July 3 Camp
Young Performers + one Camp
Young Performers + two Camps
Young Performers + three Camps
Drop-In Class First Time Registration
Parent / Guardian 1 First Name*
Parent / Guardian 1 Last Name*
Preferred Mailing Address*
Parent / Guardian 1 Cell Phone Number*
Parent / Guardian 1 Email Address*
Parent / Guardian 2 First Name
Parent / Guardian 2 Last Name
Parent / Guardian 2 Cell Phone Number
Parent / Guardian 2 Email Address
Please list the student's prior ballet experience
(New students only)
I am / We are interested in year round classes
Photo / Publication Permission
Maine Central Institute requests permission to publish photos / videos of your student and to identify your student by name on the MCI website and social media, in school publications, or in the local media (i.e. newspapers) for the purpose of promoting school news, activities and achievements.
Intending to be legally bound hereby, the undersigned agrees and does hereby release from liability and to indemnify and hold harmless Maine Central Institute of Pittsfield, Maine, and any of its employees or agents representing or related to the School. Other than in cases of neglect by the School, this release is for any and all liability for personal injuries (including death) and property losses or damage occasioned by, or in connection with any activity or accommodations for this program. The undersigned further agrees to abide by all the rules and regulations promulgated by Maine Central Institute an/or its affiliate groups and vendors.
The undersigned agrees to the statement of TERMS AND CONDITIONS OF ENROLLMENT in BBT at MCI for the 2017-18 Year-Round Program. Enrollment shall be accepted and the reservation entered upon receipt of the signed Enrollment Contract (sent at a later date). This agreement and all the terms and conditions of enrollment become binding upon the last signature date noted below.
By clicking this box, I agree that all the information above is true to the best of my knowledge. I also agree to notify the Business Office immediately if any of the above information changes.
Please send a confirmation email to the address below*: