Registration Form
Registration online is preferred at: www.rusalka.mb.ca/dance_camp/dance_ camp.html Packing List
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entire week! Ladies should have tights, bodysuits, a skirt/shorts. Men should have several t-‐shirts, and dance pants/shorts. Dancer Profile
Name
Birthdate dd/mm/yy
Age (as of July 1)
Address
City
Postal Code
Email
•
Mother’s Name
Home Phone
Cell/Work
•
Health Care #
Allergies/Health Concerns
•
Dance School
Years Experience
T-Shirt Size (Circle one):
XS S
M
L
XL
Clothing – mostly summer wear, but it gets cool at night, pyjamas, extra socks Rainwear – jacket, boots, extra pair of shoes •
Footwear – runners, sandals, and water shoes (if needed) •
Bug Spray and Sunscreen •
Personal Hygiene Items •
Water Bottle •
$10 for canteen snacks – separate envelope with name written on it •
Bag for laundry Emergency Contact Name
Contact Phone
Cell/Work
Linens – sleeping bag or comforter, bed sheets, and pillow. 2 towels and washcloth. •
Father’s Name
Home Phone
Cell/Work
Dance footwear – slippers, character shoes (ladies). Boots are optional. Gender
Prov
Dance wear – enough for an Ukrainia n
Yellow & Blue for t he
Pride Wea r
Z ab a va !
Rusalka
Ukrainian
Dance Camp
July 19-‐26, 2015 Camp registration: July 19 at 3:30 pm Dance Showcase: July 26 at 11:00 am Ukrainian Park Camp (9.5 km North of Gimli, MB) Ages 12-‐17 e ek of
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What we’re
about
Daily Activities Include: •
3-‐4 hours of Ukrainian dance instruction •
Focus on both ballet and character techniques •
Culturally relevant crafts, games, and music •
Sports and time at the beach •
Bonfires and nightly entertainment •
“So You Think You Can Dance” Competition •
Performance by Rusalka Back by popular demand….
ZABAVA night!
Payment
Cost Instruction by:
Vitali Sorokotiaguine
Vitali Sorokotiaguine is known throughout Western Canada as a talented Artistic Director who is dedicated to the preservation of Ukrainian dance. Mr. Sorokotiaguine emigrated from Ukraine in 1992 and has been the Artistic Director of Yevshan Ukrainian Folk Ballet Ensemble for over 20 years. Prior to making his home in Canada, Vitali studied in various regions of Ukraine, directed the Molodist Dance Ensemble in Zaporizhia and was a dancer/soloist with the Odessa Region Song and Dance Ensemble. We look forward to his return to camp this summer! Camp Fee $505 T-‐Shirt $20 Total $525 □ Cheque □ Cash □ Credit card
□ Credit card thru PayPal
Amount:___________________
□ VISA □ MasterCard
Card # ______________________
Expiry Date ________________
Name on Card ________________
Signature
____________________________
$100 deposit due May 15, 2015
Full balance due June 15, 2015
*Payments are non-refundable
Please make cheques payable to:
Rusalka Ukrainian Dance Ensemble
Mail registration forms & payment to:
Holly Anderson (Camp Director)
112 Harvest Drive
Steinbach, MB R5G 2C6
If you have any questions please contact
Holly at:
204.451.0501
or
[email protected]