Dancer DetailsDancer Name(Required) First Last Dancer Email(Required) Enter Email Confirm Email Phone(Required)Dancer Date of Birth(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Dancer Age(Required)Please enter a number from 14 to 25.Dancer Gender(Required) Female Male Non-Binary Prefer Not To Say Pronouns(Required) She/Her He/Him They/Them Dancer Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTürkiyeTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Master Classes Series9:00 – 10:15 AM: Rodney Hamilton, The Ballet Hispánico School | Price $15 10:30 – 11:45 AM: Dante Puleio, Limón Dance Company | Price $15 12:00 – 1:15 PM: Bradley Shelver, Joffrey Concert Group | Price $15 Enroll in 2+ Master Classes and receive a ticket to the 3:00 PM Matinee performanceHow many Master Classes are you registering for?(Required) 1 2 3 Please select one option below(Required) Joffrey Concert Group Master Class Limón Dance Company Master Class The Ballet Hispánico School Master Class Please select two options below(Required) Joffrey Concert Group Master Class Limón Dance Company Master Class The Ballet Hispánico School Master Class I am registering for all of these Master Classes(Required) Joffrey Concert Group Master Class Limón Dance Company Master Class The Ballet Hispánico School Master Class Enroll in 2+ Master Classes and receive a ticket to the 3:00 PM Matinee performance(Required) I understand I have a free ticket to the 3:00 PM Matinee Performance of ICONS Are you interested in learning more and/or being considered for the following programs? Joffrey Ballet School Training Programs Limón Training Programs The Ballet Hispánico School Training Programs Total Dancer BackgroundCurrent Dance Studio(Required)Current Dance Studio City, State(Required)Where did you hear about us? Joffrey Ballet School Website Joffrey Concert Group Website Ballet Hispánico Limón Dance Company Attended a previous ICONS Master Class Google I heard/saw it on @joffreyschool / @joffreyconcertgroup Social Media (Instagram, Facebook, etc.) Advertising on Social Media (Instagram, Facebook, etc.) Through my dance studio / academy / dance teacher Word of Mouth Joffrey Ballet School Email Newsletter Joffrey Concert Group Email Newsletter Joffrey Ballet School Audition Tour Friend/Family Recommendation Other Word of Mouth(Required) Current/Former Student Friend Parent Parent/Guardian DetailsParent/Guardian Name(Required) First Last Parent/Guardian Email(Required) Enter Email Confirm Email Parent/Guardian Phone(Required)Waiver and Refund PolicyAcknowledgment of Liability Waiver & Refund Policy Signature & Contract(Required) I understand that I will be receiving a copy of the below Liability Waiver and Refund Policy Agreements from the Joffrey Ballet School and will need to complete payment and sign the waiver for my registration to be valid. Liability Waiver(Required) I agree and understand with above. I have fully read and agree to all of the above, and I make this agreement and the representations herein in order to induce the Center for American Dance (d.b.a. Joffrey Ballet School), the Artistic/Program Director, to accept me as a student for dance and/or aerial instruction. Limited Use Photographic Release(Required) I agree and understand with above Refund Policy(Required) I agree and understand with above Dancer Signature(Required)Parent/Guardian Signature(Required)Checkout DetailsCoupon Total Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name This field is hidden when viewing the formUnique ID
