Eagle Performing Arts Center - Summer Programs Registration

July 29, 2010

Summer Programs Registration

Student's Name *
Students Date of Birth *
Email Address *
Parents' Name *
Address *
City *
Zip *
Home Phone *
Work Phone
Cell Phone

Dance Camps #1 June 21-25 1-3pm $100 ($90 Early Registration)
#2 June 28-July 2 10am-12pm $100 ($90 Early Registration)
#3 July 26-30 10-12pm $100 ($90 Early Registration)
#4 Aug 2-6 10-12pm $100($90 Early Registration)

Four Week Ballet Session (7 to 9 years)
July 5th to July 30th Tuesdays & Thursdays 9-11am $160 ($144)

Four Week Ballet Session (9-12 Yrs)
July 5th to July 30th Mon/Wed/Fri 9-11am $225 ($202 Early Registration)

Beginning Ballet Session (9 to 14 years)
July 10th to July 30th Saturdays 10-11am $40

Summer Intensive Level 1
Level 1 for beginning or pre-pointe $425 ($382 Early Registration)

Summer Intensive Level 2
Level 2 for 12 yrs and older $500 ($450 Early Registration)

Open Classes 5 Classes $6010 Classes $10015 Classes $13520 Classes $160Single Class $15
For intermediate and advanced dancers. Open ballet class meets: Mon, Wed & Fri from 10-11:30am June 8th - July 3rd July 27th - August 21st.

Total Due With Registration *

MEDICAL CONSENT: In the event of injury, I hereby authorize the program officials of the Eagle Performing Arts Center to arrange for medical services as may be deemed reasonable and necessary to the welfare of the injured, and I do hereby release the Eagle Performing Arts Center and all others from all liability in taking such action, including all action which maybe contrary to personal religious beliefs. I, the undersigned, have read this Release and Consent to medical treatment and understand all its terms. I execute it voluntarily and with full knowledge of its significance. LIABILTY RELEASE: I do hereby agree to release the Eagle Performing Arts Center and all other cooperating agencies, employees, officials, or managers thereof, from all liability for damages by reason of injures or property damages that may be sustained as a result of participation in this program. PHOTO RELEASE: I, the undersigned, hereby give Eagle Performing Arts Center, its agents, and/or assignees permission to use the photographs, motion pictures or any reproductions of my physical likeness taken of me in any manner it deems proper. I relinquish all rights, title, and interest I may have in the finished pictures, negative, and copies. I waive the right of prior approval and hereby release Eagle Performing Arts Center, its agents, and/or assignees from any and all claims from damage of any and all kinds based on the use of said material. I hereby warrant that I am a parent or legal guardian of the subject of photography, who is under eighteen years of age, and am competent to act in his/her behalf insofar as the above is concerned.
Parent/Guardian Signature *