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NC STATE D A N C E T E A M
DA N C E C L I N I C
COME DANCE WITH US!!
Saturday, February 7th
10:30 am -4:00 pm
NC State University
Carmichael Gymnasium
COME PERFORM WITH US!!
Sunday, February 8th
2:00 pm
NC State Women’s BBall vs Wake Forest
Historic Reynolds Coliseum
Registration Form: Please complete All pages (one form per child)
Registration Fee: $60/person. (Fee includes: clinic t-shirt, Lunch, Admission to game)
** We are offering a discount to those who attended our Fall Clinic! $50/person **
If dancer participated in the Fall, please fill in dancers name and email address that was used at that time:
Name:____________________________
Email____________________________________
All participants must be between the ages of 4 and 18 to participate.
Please select the group that best fits your dancers skills and experience.
Minis
Petite
(Ages 4-7)
(Ages 8-10)
Dancer’s Name:
Grade:
Junior (Ages11-14; Intermediate)
Seniors (Ages 15-18; Advanced)
Age:
DOB:
Dance Organization/Studio:
Dancer T-shirt size: (please circle one): YS
YM
YL
YXL
AS
AM
AL
AXL
Parent’s Name:
Email Address:
Address:
Phone:
Cell:
Additional T-shirts: $10 each
Please note below if you would like to order additional clinic t-shirts by entering the number you wish to
purchase.
YS
YM
YL
YXL
AS
AM
AL
AXL =
total shirts @ $10 each = $
PAYMENT: Cash and Check are accepted. Checks can be made payable to, The NC State Dance Team.
PAYMENT SHOULD BE BROUGHT WITH YOUR DANCER ON THE DAY OF THE CLINIC!!
Medical Release Form: NC State University Dance Clinic
T h i s f o r mi s t o b e f i l l e d o u t a n d r e t u r n e d t o NC State U n i v e r s i t y p r i o r t o t h e s t a r t o f t h e d a n c e
cli nic. T h e u n der s i g ned p ar e nt or gu ar d i a n s ta t e s t ha t h is / h e r s o n/ d a u g h t er h as a
re c or d on f i le a t t he c h il d’s s c h ool or a t t h e d oct or ’s of f ic e. B y s i g nin g th i s f or m t h e pa r e nt
acknowledges t h a t t h e i r c h i l d i s p h y s i c a l l y a b l e t o p e r f o r m t h e p h ys i c a l a c t i v i t i e s t h a t a r e r e q u i r e d
for p a r t i c i p a t i o n i n t h e d a n c e c l i n i c . NC State a n d a l l m e m b e r s o f t h e d a n c e c l i n i c s t a f f s h a l l n o t
be h e l d r e s p o n s i b l e f o r a n y p h y s i c a l a i l m e n t s t h a t a r e n o t d e c l a r e d p r i o r t o t h e s t a r t o f t h e
clinic.
C
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C
Peas e lis t a n y m edic a l co ndi ti o ns , a ller gies or im pair m ents t h a t th e s t af f s hou ld b e a war e of
including gluten! :
I do h ereb y gi ve p er m ission for t he belo w na m ed ch ild t o recei ve m edi cal tr eat m ent
an d t r a n s p o r t a t i o n i n c a s e o f a n e m e r g e n c y .
Child’s Name_
Parent’s Signature
Family Physician
Parent’s Name_
Emergency Contact_
Emergency Phone Number (
Policy Number
Group Number
Insurance Company
Name of Adult picking child up from the clinic
_)
Additional Information: Please Read!
Notes:
•
ALL registration forms should be sent to:
Attn: NC State Dance Team
9101 Cub Trail
Raleigh, NC 27615
•
Any questions or concerns should be addressed to Amanda Roediger, Head Coach, at [email protected]
Safety Rules:
•
Dancers MUST wear shoes or sneakers that cover the soles of the feet (no dance paws or lyrical sandals)
•
No jewelry of any kind is allowed (Exception: Medical Bracelets)
•
Please ensure that dancer has eaten prior to arrival.
•
Bring snacks AND plenty of water
FAQ’s:
1.
Will lunch be provided?—Yes! A sub style sandwich will be provided for lunch. Please make note above of any dietary restrictions.
If a sandwich is not preferred, please send a lunch with your dancer. DANCERS WILL GET A LUNCH BREAK ALONG WITH AT
LEAST 2 BUILT IN SNACK BREAKS. Make sure to send healthy snacks and plenty of water to keep them hydrated.
2.
Can I stay and watch?—Yes! We always encourage parents to leave at some point to provide some independence, however, parents
and dance teachers/coaches are welcome to stay for the duration. We just ask that you do not interfere with instruction unless it is an
emergency.
3.
If we do the clinic, do we have to do the game?—NO. If you are unable to attend the game, please still feel free to come enjoy the
clinic and a fun day of dancing!
4.
Is the clinic open to boys and girls?—Absolutely! We welcome everyone.
5.
Will there be a performance or demonstration? Yes. The NC State Dancers will do a small performance at the start of the clinic,
and there will be a full game performance run through at the end. We suggest arriving at least 20 min prior to the end of the clinic to
make sure you catch the demo.
6.
Can I take pictures?—Yes. Feel free to take pictures/videos of your child and our NC State Dancers. We ask that you please be
mindful of other people’s children however, when posting pictures on social media.
7.
Will my child have a chance to get photos taken with the team? Yes. We will designate time for each group (minis, petites,
juniors, seniors) to have pictures taken with the team. Individual pictures and pictures with Dance Team members can be taken after
the clinic has been concluded or on lunch/snack breaks.
8.
Will there be a store where I can purchase extra tshirts?—Yes. We will have a handful of extra tshirts and select costume pieces
for sale ONE HOUR prior to end time. All items are on a first come first served basis so please be mindful of that. No items can be
“held”. There is an opportunity to order extra tshirts when registering, so definitely take advantage of that if you think you or
someone in your family may want one.
9.
Can we alter our tshirts for the performance?—You may stone, paint or ribbon your tshirts if you’d like. We do ask that no shirts
be cut to bear the midriff or hang off the shoulders. We also ask that you make sure the FULL NC State logo remains in tact and
legible.
10. How will I know if you have received my registration?—A confirmation email will be sent to you within a week of receiving
registration forms. Confirmation emails, will detail ticket purchasing, gameday information, and pick up/drop off information.