2023 Dance School Application

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This form is only for those who applied to compete in the 2023 USA IBC. Due to the outstanding level of talent, we have chosen to automatically accept all applicants to the 2023 USA IBC Dance School. Should you have any questions, please contact Madalyn Burke, ids@usaibc.com

Please have Medical Information & $200 deposit ready before beginning the form.

2023 Dance School App, (Competition Applicants)

This form is ONLY for those that applied to compete at the 2023 USA IBC, and who would like to attend the 2023 International Dance School.

"*" indicates required fields

Step 1 of 5

Click next (below) if you are ready to begin your application.

Required Student Information:

Applicant:*

First Last

Age as of June 10, 2023*

Contact Email:*

Confirmation emails will be sent to this address.

Enter Email Confirm Email

Enter your MAILING ADDRESS in the space provided below:*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of roommate preference (if known):

Note: Roommate requests will only be accepted if requested by both roommates

Would you like to be considered for a scholarship for year long study in 2023-2024 or summer study in 2024?*

Scholarships are offered by programs around the country

Medical Information:

Please list any/all allergies (if none, put N/A):*

Describe any injuries in the last year (if none, put N/A):*

Any presently existing or persistent condition/infection (if none, put N/A):*

Please list any medications you are currently taking (if none, put N/A):*

Dietary restrictions (if none, put N/A):*

Will you bring prescription medications to the Dance School? (Please list or put N/A)*

Current Physician's Name:

First Last

Physician's Office Phone:

Emergency Contact

Name:*

First Last

Relationship to student:*

Cell Phone:*

Home or Work Phone:*

Health Insurance Information:

Are you insured?*

Health Insurance Company:*

Name on Insurance Card:*

First Last

ID Number:*

Plan Codes:

Claims Phone Number:*

USA IBC Dance School Student Agreement

Consent for medical treatment, liability release, and rules agreement:

I/We hereby give my permission to the USA IBC Dance School personnel, chaperones, and USA IBC staff to authorize any emergency medical treatment, anesthetics, and/or operations that may be required by the applicant during the IBC Dance School from June 9-24, 2023. I understand that I am responsible for any and all payments as a result of such care or medical treatment. I/We hereby release the USA IBC Dance School and Belhaven University, their agents, employees, and volunteer assistants, from any liability whatsoever arising out of any injury, damage, or loss which may be sustained by the student during the dance school.

During the USA IBC Dance School, students will participate in special weekend activities. These activities may include excursions to locations off campus from Belhaven. I hereby give permission to the USA IBC Dance School to take the student to off campus locations. I hereby release the USA IBC Dance School, and their agents, employees, and volunteer assistants, from any liability whatsoever arising out of any injury, damage, or loss which may be sustained by the student during these activities.

I/We grant to USA International Ballet Competition (USA IBC), its representatives and employees the right to take photographs of my child in connection with the USA IBC Dance School. I authorize USA IBC, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that such photographs of my child may be used without my name and for any lawful purpose, including for example such purposes as USA IBC Dance School promotion and web content.

Student Rules Agreement:

All students are expected to abide by the policies of the USA IBC Dance School in addition to all rules set forth by Belhaven University. Please read the rules below and select ‘I agree’ from the drop-down menu.

I have read and agree to all rules outlined in the USA IBC Dance School handbook.
I will work to prepare my body for the significant physical demands of this school.
I realize there will be people from many backgrounds attending this school and I will show respect for all.
I understand that the teachers and staff are in a place of authority for my benefit and protection, and I will honor their leadership while attending this school.
Drugs, alcohol, and smoking are strictly prohibited.
Inappropriate or offensive use of technology (computers, phones, cameras, social media, etc.) is prohibited. Bullying or harassment of any kind will not be tolerated. Additionally, phones must be turned off and put away during all classes and evening performances.
Profanity (obscene, disrespectful, or discriminatory language) and vandalism of any kind will not be tolerated.
I understand that I may be sent home if I do not follow the rules of the USA IBC Dance School or Belhaven University.
All prescription medications will be given to my counselor at the beginning of the dance school and will be administered daily by said counselor (applicable to all students under 18 years of age).
I will behave in a respectful manner at the USA IBC evening performances per counselor instructions and in accordance with appropriate theater etiquette.
Class level placement during the dance school is determined at the discretion of USA IBC Dance School faculty and is FINAL. All students will have the opportunity to take class from each faculty member. I agree to accept my placement level and put forth my best effort in class.
If my contact information (mailing address, phone number, or email) changes in any way before June 9, 2023 I will notify the USA IBC Dance School administrator via email at ids@usaibc.com
I will complete a transportation form and return to the Dance School administrator via email at ids@usaibc.com no later than May 5, 2023.

By signing this electronically, I agree with the policies, terms, and conditions set by the USA International Ballet Competition.

Choose from drop-down menu below:*

Electronic Student Signature*

First Last

Electronic Parent Signature*

First Last

Tuition Payment

Deposit or Full Payment*

Deposit required by March 31.

Total

Coupon Code

Credit Card

Card Details

Cardholder Name

Pay the remainder of tuition balance

2023 Dance School Tuition Final Payment (Competition Applicants

Tuition Payment Form

"*" indicates required fields

Step 1 of 2

Click next below if you are ready to submit your final payment for the 2023 Dance School

Required Student Information:

Applicant:*

First Last

Contact Email:*

Confirmation emails will be sent to this address.

Enter Email Confirm Email

Tuition Payment

This final payment will be added to your $200 deposit that was paid in the Dance School application. This will be your complete and final payment.

Product Name

Off - Campus Balance $1,000

On - Campus Balance $1,800

Total

Credit Card

Please check if you have activated a Stripe feed for your form.

Billing Address (where you receive credit card statements)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country