2008 SUMMER REGISTRATION
(Please
Print)
Student's Name___________________________ M/F _____ Birth Date______________
Age_____
Parents' Names_______________________________ Mom's Work
Phone____________ Ext. _____
Address/City/Zip______________________________________Cell__________________________
Home
Phone____________________ Email
____________________________________________
Photo Release I hereby give permission for
Debra Collier's School of Dance to take and use photographs of my child for
promotional use for the school. Signature of Guardian:
________________________________
Please take a moment to let us know which of the following influenced
your decision
to register for class(es).
Newspaper Ad: r
Times Union r
Other Newspaper_________________
r Studio Brochure,
received from:
________________________
Website: r
Direct to
www.collierdance.com r
Through a link from:
________________________
r Yellow Pages
r Radio Ad r
Direct Mail
r
Birthday Party r
North Point Cinema Ad/Workshop
r Studio's outdoor Sign
r
Billboard r
Other:
________________________________________
r Referred by:
________________________________________
Please place a check mark by all classes/camps
for which you are registering:
* Each workshop of the same theme will have unique
combinations. Material will not be repeated.
|
Six-week |
Specialty |
Dance Camps |
Shani Barnett Workshops |
| r
Ballet Technique (Tues, 4:00-5:30 pm) |
r Turn Technique (June 24) | r I: Drama Camp | r
Jazz & Hip Hop 8 to 11 year-olds |
| r
Ballet Technique (Thurs, 4:00-5:30 pm) |
r Tap Turns &
Technique Beginner to Intermediate (June 25) |
r
II: Pretty Princes Camp (June 23-25-27) |
r
Jazz & Hip Hop 12 to 14 year-olds |
|
r
Pre Pointe/Pointe |
r Tap Turns &
Technique Advanced (June 26) |
r III: Boys' Athletic Boot Camp | r
Jazz & Hip Hop 15 year-olds & up |
| r
Pointe Technique (Thurs, 1:30-3:30 pm) |
r Jazz Progressions (July 7) | r IV: Cinderella Camp | r Auditioning for a Music Video 8 year-olds & up |
| r
Conditioning (Tues, 11:00-11:30 am) |
r Jazz Progressions (July 14) | r V: High School Musical® Camp | r
Modern 9 year-olds & up |
| r
Conditioning (Thurs, 3:30-4:00 pm) |
r Intro to Modern (July 15) | r VI: Ballerina Barbie® Camp | |
| r Yoga* (4 week session June 24-July 15) | r
Ballet and Beyond...
(July 17) |
r VII: Pretty Princess Camp (July 14-16-18) | |
| r Pilates | r Jazz Turns & Leaps (July 7) | r VIII: Belle's Ball | |
| r Tiny Tots | r Jazz Turns &
Leaps (July 14) |
T-Shirt size for
Dance Camp Participants: r6-8 r10-12 r14-16 rSA rOther_____ |
|
| r Hip Hop | r Jazz Turns &
Leaps (July 16) |
||
| r
Mommy & Me (Tues. 5:30-6:00 pm) |
|||
|
r Mommy & Me
(Thurs. 10:00-10:30 am) |
|||
Debra Collier's School of Dance w 1269 Husky Trail w Warsaw, IN 46582 w (574) 267-7055 w www.collierdance.com