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CHILDREN'S DIVISION
HANDBOOK ACKNOWLEDGMENT

This form must be completed by all Children's Division parents as acknowledgment that they have received and reviewed the 2018-2019 Otto M. Budig Academy Student and Parent Handbook.

I acknowledge that I have received a copy of Cincinnati Ballet’s 2018-2019 Otto M. Budig Academy Student and Parent Handbook, and I have read, fully understand and agree to abide by all policies within the Handbook.

I understand that compliance with the rules and policies contained in the Handbook is a requirement for continued enrollment and that my student’s failure to follow the rules and policies may result in disciplinary action, up to and including dismissal from the program at my expense.

 

First Student's Name

First Name*

Last Name*
First Student's Date of Birth*
First Student's Signature*
Second Student's Name

First Name*

Last Name*
Second Student's Date of Birth*
Third Student's Name

First Name*

Last Name*
Third Student's Date of Birth*
Fourth Student's Name

First Name*

Last Name*
Fourth Student's Date of Birth*
Fifth Student's Name

First Name*

Last Name*
Fifth Student's Date of Birth*
Sixth Student's Name

First Name*

Last Name*
Sixth Student's Date of Birth*
Seventh Student's Name

First Name*

Last Name*
Seventh Student's Date of Birth*
Eighth Student's Name

First Name*

Last Name*
Eighth Student's Date of Birth*
Ninth Student's Name

First Name*

Last Name*
Ninth Student's Date of Birth*
Tenth Student's Name

First Name*

Last Name*
Tenth Student's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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