Camp Information
Dates: June 20-23
Time: 1 p.m. - 2:15 p.m.
Location: Heritage Academy, 333 Greene Street, Augusta, GA 30901


1. Students will be expected to have transportation provided to and from the program facility. 
2. Students will need to dress comfortably. Gym clothes are appropriate.
3. Ballet shoes are not necessary because students will not be wearing shoes for most of the class period. 

Hope Ballet Theatre Recital: Thursday, June 23 at 6:45 p.m.
Location: Heritage Academy Auditorium

Family and friends of the Hope Ballet Theatre students are encouraged to attend the Hope for Augusta Recital. Students of Hope Ballet Theatre will perform all the styles of dances that was learned.

Registration Form

Augusta Ballet will send each registrant an email notifying whether the applicant has been accepted into the camp or whether they will be put on the Wait List. The Wait List will be created for registrants who were not apart of the first fifteen to complete the application. Those on the Wait List will only be notified should an opening become available.

Please SUBMIT the Registration Form by Thursday, June 16, 2016, 12:00 PM.

Note: The asterisk (*) denotes a required field. If no asterisk is present, that field is optional. 

Student's Name *
Student's Name
if different from above
Student's Date of Birth *
Student's Date of Birth
Primary Guardian's Name *
Primary Guardian's Name
Primary Guardian's Address *
Primary Guardian's Address
Primary Guardian's Phone *
Primary Guardian's Phone
Secondary Guardian's Name *
Secondary Guardian's Name
Secondary Guardian's Address *
Secondary Guardian's Address
Secondary Guardian's Phone *
Secondary Guardian's Phone
Please list any medical conditions of the student.
Please list any allergies of the student.
Student's Medication *
The student:
If there is anything else the staff should be aware of, please list below.
Doctor's Phone Number *
Doctor's Phone Number
Insurance Phone Number *
Insurance Phone Number
Primary Guardian Commitment *
The Primary Guardian is giving the above named student permission to participate in Hope Ballet Theatre: College for Kids Camp. The Primary Guardian will ensure the child is transported to the program's facility between 12:45 p.m. - 1 p.m. every day the program is scheduled. The Primary Guardian will also ensure the child is picked up from the program's facility between 2:15 p.m. - 2:30 p.m every day the program is scheduled. The program's recital will be in the evening of June 23, and the Primary Guardian will ensure the child is available with adequate transportation to participate in the event.
Medical and Liability Waiver *
The Primary Guardian represents to Hope for Augusta herein referred to as HFA, a non-profit organization, and Augusta Ballet, also a non-profit organization, that he/she is the legal guardian and natural parent or the legal guardian of the above named student; and the Primary Guardian does hereby consent to such minor taking part in Hope Ballet Theatre: College for Kids Camp, with full understanding that there is always the risk of injury, illness, loss, death, and possible consequent expenses for the medical, diagnostic, and curative treatments, and incidental loss and expense, and the Primary Guardian does for him/herself and for and on behalf of such minor assume the risk of such expense and does hereby wholly release HFA, Augusta Ballet, and any representative from any responsibility or liability; and waives any claims or causes of action against it or its agents that might rise on account of loss, injury, death, or expense occasioned by any sort of accident or any other circumstances involving such student/students, and agrees to hold harmless in event any such claim should arise; and the Primary Guardian agrees to abide by the rules and regulations, supervision and discipline set applied by HFA, Augusta Ballet, and its agents, and does hereby authorize HFA, Augusta Ballet, or its representatives or other agents to arrange for any needed medical treatment or x-rays, and hold harmless HFA and Augusta Ballet from any such expenses. The Primary Guardian will reimburse HFA and/or Augusta Ballet fully or furnish payment or insurance for any such payment, at his or her own expense. The Primary Guardian also agrees to pay in full for any property damage caused by his/her student.
Media Release *
I consent to and allow Hope for Augusta and Augusta Ballet any use and reproduction of all photos/videos taken of the above named student during their participation of Hope Ballet Theatre: College for Kids. I understand Hope for Augusta and Augusta Ballet will own the photos/videos and have the right to edit them or prepare derivative works, for the purposes of promotion, advertising, and public relations. I hereby consent to this use of the student's name, likeness, or voice, and I agree that such use will not result in any liability.