Registration Form For Workshop for Absolute Beginners Date Name Address Home Phone Cell or Other Email Address Date of Birth Place of Employment Work Phone   Does your company have a matching gift program? Yes No   Emergency Contact Phone Number Physician Phone Number     Medical conditions, allergies or special needs:     Previous ballet training (optional):     Special skills and interests:     How did you hear about Western Ballet? :     Would you be interested in helping in Western Ballet's productions? Yes No Intended Payment Method  Cash Check Credit Card PayPal Please bring your cash, check or credit card payment to Western Ballet, or pay immediately with PayPal.   Step 1: Register by completing the above form, READ THE WAIVER , and then click "Submit". By submitting this form (Clicking on SUBMIT) you are stating that you have read and are in agreement with the waiver.     Step 2: PayPal   Pay online immediately with PayPal or bring your cash, check or credit card payment to the Western Ballet Office. Payment must be received in advance to guarantee your place in the class.