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225-293-1213
12240 Coursey Blvd Ste F / Baton Rouge, LA 70816
www.brdance.com
Summer Intensive th
th th July 13 , July 15 , July 20 , and July 22nd (Mondays and Wednesdays) Time 4:15 5:15 6:00 Class Mini Ballet Jr. Jazz Mini Lyrical Room A A A Time 4:30 5:15 6:00 6:45 Teen/Adv Contemporary A 6:45 A 7:30 7:30 Class Jr. Tap Mini Tap Teen/Adv Tap Jr Hip Hop Room B B B Teen/Adv Hip Hop B B July 14th, July 16th, July 21st , and July 23rd (Tuesdays and Thursdays) Time 4:15 5:15 Class Jr. Ballet Jr. Lyrical Room A A Time 4:30 5:15 6:00 Mini Leaps and Turns A 6:00 6:45 Teen/Adv Jazz A 6:45 7:45‐9:00 Teen/Adv Ballet A Class Mini Jazz Mini Hip Hop Teen/Adv Leaps and Turns Jr. Leaps and Turns Room B B B Note: Our summer intensive program is designed for the serious dancer that wants to really fine tune his/her technique. Dancers must be A MINIMUM of 6 years old and have had at least 2 years of dance training before registering for these classes. Class placement is based on skill level and not limited to age groups. Please let us know if you have any questions about placement, one of our teachers would be HAPPY to assist you in finding the perfect classes for your dancer. Summer Intensive Pricing: 4 Class Punch Card $45 8 Class Punch Card $75 10 Class Punch Card $100 12 Class Punch Card $125 16 Class Punch Card $150 Dream Team Requirements: Any dancer wishing to audition for the 2015‐2016 BRDC Dream Team must take a minimum number of classes at our summer intensive. Dancers will purchase a punch card that will have to be signed off on at every class. It is the dancer’s responsibility to have these cards signed at every class. Dancers that are interested in auditioning for the BRDC Dream Team are required to join us for summer classes. Any dancer that was on the Dream Team for the 2014‐2015 dance season will have the following requirements: 2 ballet, 2 tap, 2 jazz, 2 lyrical/contemporary, 2 leaps and turns or 2 hip hop classes. Dancers that were not on the Dream Team for the 2014‐2015 dance season will have the following requirements: 3 ballet, 3 tap, 3 jazz, 3 lyrical/contemporary, 3 leaps and turns or 2 hip hop classes. *Dancers may take any combination of classes in a lower level as long as the class is not at capacity. ************************************************************************************* Dancer_______________________________________________ DOB____________ Age__________ 4 class _______ 8 class _______ 10 class _______ 12 class _______ 16 class _______ Parent Name_________________________________ Parent Cell Phone__________________________ In case of emergency and parent cannot be reached, please call:________________________________ Reltationship to dancer:__________________________ Phone number:_________________________ Email_______________________________________ Payment Method ____Cash ____Check ____C/C How did you hear about us? ____________________________________________________________ Do you plan on trying out for the BRDC Dream Team? Yes____ No____ I would like more info_____ ****Please complete Hold Harmless Waiver attached**** Baton Rouge Dance Connection/The Dance Connection Hold Harmless Agreement In consideration for my child being permitted to participate in The Dance Connection, LLC program (referred to as “the Studio”), I/We ______________________parent(s) and/or legal guardian(s) of____________________, agree to the following provisions: Acknowledgment of Risks: I/We understand that there are numerous risks associated with participating in dance activities, including those risks present during classes and activities, on the premises before, during, and after various classes and events, as well as in travel to and from the Studio and various venues of performance. Some of the specific risks include the placement of unusual stresses on the body, falls and tripping which may lead to accidents resulting in, but not limited to, mild to severe bodily injury. I/We understand that the Studio cannot be responsible for any injuries or damages experienced by my/our child during her/his participation in such activities. Medical Care: In an emergency situation, when parental permission is not available, I/We hereby grant and give my/our permission for a staff member at the Studio to seek emergency medical treatment for my/our child. In my/our absence or inability to communicate with emergency and hospital personnel, I/We hereby grant the Studio authority to release for the purposes of providing medical treatment, my/our child to the care of medical personnel or physicians as the Studio determines as reasonably appropriate. Media Relations: By signing the Agreement and Releases, I/We consent and give permission to the Studio, and those acting under its authority, to use the name or likeness of my child for the purpose of marketing the studio to the media. Release, Covenant Not to Sue, Waiver of Liability and Indemnification Provisions Parents (of Minors): I/We have read and clearly understand the terms of this Agreement. I/We give my/our permission for my/our child to participate in all Studio activities, including those described above. I/We also release and hold harmless the Studio, its officers, directors, agents and employees, and those acting under its authority, from all actions, claims and liabilities relating to my/our child’s participation in any and all programs. I further agree to indemnify and hold harmless and defend Jennifer Cothren, The Dance Connection, LLC, it’s teachers, officers, agents, and employees from injuries, damages and losses sustained by me or my child arising out of, connected with, or in any way associated with the activities of the program(s). I have read and fully understand the above program details and waiver and release of all claims. Signed:_____________________________________________________ Date:____________________ Child Name:________________________________ Parent Name:______________________________ Address:_____________________________City:_______________State:_________Zip:_____________ Home Phone/Cell:____________________________Work Phone:_______________________________ List any medical conditions that we should be aware of: _____________________________________________________________________________________
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