Summer Dance Camp Registration for 2008
Dancer’s Name:__________________________________________________________ Parent’s Name: ___________________________________________________________ Phone number:_________________________ Cell number:_______________________ Age of Dancer:_________________________ Grade:____________________________ Address:________________________________________________________________ Last completed class at TMDA:______________________________________________ June 16-August 2, 2008
WARNING OF RISK TO PARTICIPANT
The Maine Dance Academy (TMDA) is not responsible for providing medical accidental injury insurance on students. Parents/guardians are required to provide adequate accidental and medical insurance for their child enrolled in TMDA. My child and I are aware that participation in all TMDA dance classes is potentially hazardous and may involve risk of injury. TMDA, Colleen DuPlissie, the teachers, the assistants, the secretaries and the owner of the property at 15 Sweden Street, Caribou, ME shall not be held responsible for treatment, injury or losses related to TMDA. Neither Colleen DuPlissie, nor any teacher, nor the studio, nor the owners of said property are liable for the loss or damage to personal property. As a parent, guardian, and/or participant, I am aware of the hazards and my ability or my child’s ability to participate. Each student may decline to participate in any activity but only with written permission of a parent or guardian. Please inform the teachers of any physical limitations or conditions. I hereby, for myself, my heirs, executors and administrative waive and release all rights and claims against The Maine Dance Academy, it’s employees, volunteers and owners from all losses, injury, damages, fees and other expenses arising out of, or in connection with all our participation at The Maine Dance Academy. I have also read the entire rules and regulations posted on TMDA’s website and will adhere to them accordingly.
Parent Signature:_____________________________________ Date:_________________ Please fill in the requested information above and return it by March 1, 2008 with your Non-refundable $20.00 registration fee to: The Maine Dance Academy, c/o Colleen DuPlissie, 82 Solar Drive, Caribou, ME, 04736. You will only be considered registered at TMDA when a completed form and registration fee is received by TMDA. T-Shirt Size (circle one): Childs: S M L XL Adult: S M L XL
Dance camp requirements: All students will need to have tap shoes, ballet shoes and jazz shoes/sneakers for camp. Pointe dancers will need to bring their pointe shoes. Summer camp is more relaxed so we will not require dancers to be in all black. Parents will need to be available to change shoes for children in the 5-8 year old bracket.