Student Matinee Registration Request

Name*

First Last

Email*

Phone Number*

Name of School*

Is this a Philadelphia Title 1 School?*

Yes
No (If you are not a Title 1 school please email Randy Benedict at [email protected] to be placed on a waiting list if seats become available.)

Are you a participant in one of the Pennsylvania Ballet Community Engagement programs?*

If yes, which one?

Have you attended a student matinee or dress rehearsal before?*

School Address*

Street Address Address Line 2 City State ZIP Code

School Principal*

First Last

Principal's Phone Number*

Grade Level of Students*

Number of Students (Max. 150)*

Please enter a number less than or equal to 150.

Desired Performance*

Terms*

I understand that this form is only a registration request, and does not guarantee that my group will attend a performance.
I understand that failure to attend a performance, or a significant reduction in attendance numbers, without notification will result in removal from all further participation in the program (if there is a cancellation or a reduction in attendance numbers, please contact [email protected]).
I understand that I may not increase the number of students attending (if there is a decrease in the number of students attending, please email [email protected].
I understand that for school groups with more than 10 students, there must be at least 1 adult chaperone per every 10 students.
I understand that children younger than FIRST GRADE will not be admitted to the Student Matinee performances.