2011 SUMMER CAMP REGISTRATION by ashrafp

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									                                       SIMPLY NIKKI DANCE STUDIO
                            SUMMER DANCE CAMP REGISTRATION FORM
                               Harrison Avenue Jeannette, PA 15644*724-875-0686

Participant’s Name:                                                                                                     Sex: M/F

Address:                                                                                        Birthday:

Current Age: Yrs months    Currently Enrolled: Y/N
…………………………………………………………………………………………………………….

Parent’s Name                                                                       Phone 1:

Address:                                                                            Phone 2:

Email (optional):
.................................................................................................................................................

Emergency Contact:                                                                              Phone:
................................................................................................................................................

I am interested in : (Please check one)
□ Dance & Discover □Skill Building Workshop □ Technique Intensive □ Other
…………………………………………………………………………………………………………….
Please answer all of the following questions to best of your knowledge and ability:

Do your child have any medical conditions, food allergies, or additional needs we should be aware of?
Yes/No



Did you attend our summer program last year? Yes/ No
Please name your deciding factor, if any, for attending this year’s program?


Release of Liability:
The undersigned participant or parent or guardian of the child who is an applicant participating in
any of the Simply Nikki Dance Studio programs administered by the Simply Nikki Dance Studio at
Fort Pitt Commons, releases said Studio and those acting for it from any and all liability for any
and all injuries sustained to said participant or child in any of the offered programs. The signer
also understands and agrees to pay the full amount to be accepted into the program with no
refund guarantee for failure to attend or contingent reasons after the 5th of July.


Participant/parent/guardian signature                                               Date

 Actual registration is not complete until a form and payment have been received. Anyone registered before June
14, 2011 will receive a 10% discount off their course fee. All attendees will be responsible for the entire course
fee in advance; payments will not be pro-rated according to actual attendance. After registration is complete all
cancellations will result in a $30 processing fee. By signing the above you acknowledge and agree with all of the
terms and conditions listed in this document, summer camp packet information including price guide, and related
materials.
                               SUMMER CAMP GUIDELINES
                               TODDLER PROGRAMS

CLASS POLICIES:
    Walking skills are necessary for your child’s safety. Please do not enroll your child
       unless he/she is stable on their feet.
    Potty Training is appreciated, but not mandatory. This is a class especially
       designed for toddlers. Your child will only be present for 2 hours, so unless there
       is an urgent situation your child can be changed before and after class. Please
       have your child arrive in a fresh diaper, and we will make changes only if
       necessary.
    Please have your child arrive in comfortable, non-restrictive play clothing.
       Dance, movement, and crafts are a vital part of our program so please have your
       child dressed appropriately. Please check the syllabus for class activities. SNDS
       will not be responsible for any stained or damaged clothing or articles.
    Please clearly label any items your child brings. Have a small bag clearly labeled
       with all the necessary products your child may need for diapering or medical
       conditions. If there is no need for an item please leave it at home. Remember to
       only include child friendly items that are clearly labeled. SNDS will not be
       responsible for any lost, stolen, or damaged items.
    All children will be accompanied by an adult at all times. (restroom, outside,
       parent pick-up). No child will be dismissed to an individual who has not been
        approved by the signing parent/guardian without prior notice.
       If there is ever a behavior problem your child will be asked to take some time to
        him/herself. If the problem persists, we will notify you and a meeting may be
        scheduled. If the problem is still not resolved expulsion from the program may
        result with no refund given. Expulsion can occur at any time if any child or
        persons responsible for are physically, emotionally, or mentally abusing fellow
        children, staff, parents, or partners of SNDS. Expulsion may also occur at any time
        if any child or responsible persons is caught vandalizing SNDS or any of its patrons
        or affiliates.

CLASS GUIDELINES:
    Never force a child to participate. Allow your child time to get comfortable with
       their new environment. Remember, everyone has an off day.
    2 hours is a long time to keep a child’s attention. We will provide a snack break
       after 1 hour of the session concludes. Your child will be given the scheduled group
       snack unless dietary restrictions are noted in the registration form. Please keep us
       updated of any changes. Feel free to bring in your own snack as well.
    Although the curriculum is tailored for your child, attentions spans at this age are
       short. Your child may wander from time to time and we understand this. There
       are intervals of structured class and free movement.
    Once class has begun please remain in the designated waiting area if staying on
       the premises. When adults stay or are visible through windows it causes chaos
       and slows the learning process.
    Please call or inform us of any early dismissals so we can have your child ready for
       you. When picking up early, wait for the music to stop and then knock on the
       door to ensure you’re heard. Likewise, if an absence is necessary please inform us
       at your earliest convenience. Camp dues will not be pro-rated.
    Any child not picked up by within 30 minutes after the end of class will be taken
       to the nearest police station. If you are going to be late please call so we know to
       wait for you. JEANNETTE POLICE DEPT. 110 S 2nd St. Jeannette, PA 15644
                            DANCE AND DISCOVER
                            THURSDAY JULY 5 - 26
                                 CLASS SYLLABUS
      THEME                     FOCUS                      CRAFT                       SNACK
WK1   INVENTIONS &         Meet teachers and              SCIENTIFIC            YOGURT/APPLESAUCE
      INNOVATIONS          classmates, science           SUBSTANCES                 PRETZELS
                          experiments, puzzles,                                      WATER

WK2     CAMPING                Teamwork and                 T-SHIRTS             ANIMAL CRACKERS,
                          cooperation activities,                                 GRAHAM CRAKERS
                          listening and imitating                                  MARSHMALLOWS
                             skills, coordination                                      BUG JUICE
WK3   I SPY A MYSTERY     Critical thinking skills,         DISGUISES                    FRUIT
                             ballet movements,                                         POPCORN
                        individuality exploration,                                   JUICE/WATER
                               direction taking
WK4   80’s ROCKSTAR         Colors exploration,           CD & PHOTO                GRANOLA BARS
          PARTY!         counting exercises, gross
                           motor skills, balance,
                                      props
                        *Classes are subject to substitutions of materials without prior notice if needed.
                    SUMMER DANCE CAMP PROGRAM
                        TECHNICAL (ages 9-UP only)
         Thank you for inquiring about our new summer dance camp program, the
technical course, focusing on proper technique and professionalism. This course was
designed for students who are serious about the art of dance. Each class will focus on
proper technique, execution, and tips to get more out of your dancing. Professionalism is
essential for all students registered for this class, so it is imperative you arrive on time with
proper dress and shoes. Classes may consist of a variety of ages, but the goal is the same
for everyone. Each dancer will get the instruction he/she needs to improve their skills and
reach the top of their field. Class is open to anyone ages 10-up, but previous training is
required. Please read below for class requirements and helpful suggestions! Thank you for
your interest.
                       ALL CLASSES WILL BE HELD ON TUESDAY MORNINGS:
                                             CLASS SCHEDULE

                                   9:00-9:45 am              MODERN/YOGA/PILATES
                                   9:45-11:30 am             BALLET
                                   11:30-12:30 am            POINTE

You must be enrolled in ballet and have permission from the instructor to take Pointe
CLASS POLICIES:
    Bodysuits are required for all classes; pink tights are required for ballet disciplines.
    Proper shoes are required to take class
    All hair must be securely back with no hair (bangs) in the face; buns required for
       ballet and Pointe students.
    Please bring water to keep hydrated
    Please use the restroom before and after class.
    Please turn off all cell phones and other electrical devices before class
    Please arrive on time, ready to go
    Please arrive to class with a positive attitude ready to work; if you get frustrated
       with a step take a breath and try again; everyone has “off-days”
    If there is no need for an item please leave it at home. SNDS will not be
       responsible for any lost, stolen, or damaged items.
    If there is ever a behavior problem you will be asked to leave class. If the
       problem persists, we will notify your parent and a meeting may be scheduled. If
       the problem is still not resolved expulsion from the program may result with no
       refund. Expulsion can occur at any time if any child or persons responsible for are
       physically, emotionally, or mentally abusing fellow children, staff, parents, or
       partners of SNDS with no refund. Expulsion may also occur if at any time if any
       child or responsible persons is caught vandalizing SNDS or any of its patrons or
       affiliates with no refund.
    Parents: once class has begun please remain in the designated waiting area if
       staying on the premises.
    Please call or inform us of any early dismissals so we can be prepared. If picking
       up your child early, wait for the music to stop and then knock on the door to
       ensure you’re heard. Likewise, if an absence is necessary please inform us at your
       earliest convenience.
    Any child not picked up by within 30 minutes after the end of class will be taken
       to the nearest police station. If you are going to be late please call so we know to
       wait for you. JEANNETTE POLICE DEPT. 110 S 2nd St. Jeannette, PA 15644
                             SUMMER CAMP GUIDELINES
                             SKILL BUILDING WORKSHOP
CLASS POLICIES:
    Bodysuits are required for all classes; non-restrictive dance type clothing is
       permitted with your bodysuit
    Please use the restroom before and after class.
    Please turn off all cell phones and other electrical devices before class
    Please arrive on time, ready to go
    Please arrive to class with a positive attitude
    If there is no need for an item please leave it at home. SNDS will not be
       responsible for any lost, stolen, or damaged items.
    If there is ever a behavior problem you will be asked to leave class. If the
       problem persists, we will notify your parent and a meeting may be scheduled. If
       the problem is still not resolved expulsion from the program may result.
       Expulsion can occur at any time if any child or persons responsible for are
       physically, emotionally, or mentally abusing fellow children, staff, parents, or
       partners of SNDS. Expulsion may also occur if at any time if any child or
       responsible persons is caught vandalizing SNDS or any of its patrons or affiliates.
       Refunds will not be granted.
    Parents: once class has begun please remain in the designated waiting area if
       staying on the premises.
    Please call or inform us of any early dismissals so we can be prepared. If picking
       up your child early, wait for the music to stop and then knock on the door to
       ensure you’re heard. Likewise, if an absence is necessary please inform us at your
       earliest convenience. Please note dues will not be pro-rated.
    Any child not picked up by within 30 minutes after the end of class will be taken
       to the nearest police station. If you are going to be late please call so we know to
       wait for you. JEANNETTE POLICE DEPT. 110 S 2nd St.
                                   Jeannette, PA 15644
                            SKILL BUILDING WORKSHOP
                       TUESDAY JULY 14 - TUESDAY AUGUST 20
                                     CLASS SYLLABUS
                                   THEME                               FOCUS
               WK1                 HIP HOP               Learn basic positions, techniques, and
                                                           vocabulary. Guest instructor TBA

               WK2                TUMBLING                Tumbling techniques. Field trip to
                                                           Westmoreland Gymnastics TBA

               WK3                 MODERN                 Various modern techniques/styles.
                                                             Laurel Ballet Guest Teacher.

               WK4              JAZZ/THEATRE           Classic Jazz and Theatre Presence. Stage
                                                                  Right Instructor TBA.


                             *Classes are subject to substitutions of materials without prior notice if needed.
    *All materials are owned and operated by SNDS and its staff, please do not copy or sell this information.
                  Permission Slip


Purpose of Trip: ____ Dance Education_                                         _____________

Name__________________________ School _SIMPLY NIKKI DANCE STUDIO_

Trip Date: ___ _/___    _/__             _

Destination: ____                                                _____________________

Advisor(s): ___________                                          __________________________

Departure Site:                                          Departure Time:

Return Site:                                             Return Time: _______ ____

Mode of Transportation: (if necessary)

_______


I give my permission for my child to participate in this trip.

    ________________________________                  ___________________________
      (Signature of Parent/Guardian)                    (Date)

    TOTAL MONEY DUE: $

I further agree to hold the above named unit and its staff blameless for any accidents that
might occur during this outing except for clear acts of negligence or non-adherence to SNDS
policies and guidelines.

In case of emergency, I can be reached by phone at ____________________ or
____________________.

If I cannot be reached, please contact _________________________ at ____________________.

Signed: ______________________________ Date: _______________ (Parent or
Guardian)

OPTIONAL:

I can drive: TO /FROM            I can: Chaperone/Attend

Vehicle Make_______ Model_________ Year____ Reg. # ___________ # of Seatbelts________
                      SUMMER CAMP PRICE GUIDE
DANCE AND DISCOVER:

        4 week session/one class per week for four weeks
              $100 course fee, $25 materials fee = $125 total course fee
                 Dues will not be pro-rated; a $30 registration fee will be retained in the event of
        cancellation.




SKILL BUILDING WORKSHOP:

        4 week camp/one class per week for              four weeks
        Foundation Building: Mandatory                   $30 (base class)
        Each additional workshop                         $25(each)
        Full Participation Special Discount              $100 ($5 dollar savings!)
        (Entire 6 week course)




TECHNIQUE INTENSIVE:

        4 week program/one class per week for four weeks
        One Discipline    $40 or $80
        Two Disciplines   $80 or $120
        Three Disciplines $160

Please call for information on additional services:

    o   Birthday Parties
    o   Private Instruction
    o   Fitness Instruction
    o   Practice/ Studio Space



PLEASE READ AND AGREE TO THESE TERMS BEFORE SUBMITTING YOUR REGISTRATION
                              AND PAYMENTS:

Please note due to unforeseen circumstances; dates, times, and/or curriculums may be substituted
without prior notice. If a cancellation is made on the part of the studio: 1. an alternate class will
be offered; if no class is offered 2. a refund will be given on a pro-rated scale pertaining only to
cancelled classes. No student will be permitted into their class until their entire course fee is paid in
full. Cancellation of participation will result in a $30 non-refundable fee. Dues will not be pro-
rated due to absences for any reason.

								
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