Registeration Form 2010

NOTE**call 564-1025 to register
Registration Form
To register for the upcoming FALL and SUMMER classes, Please fill out the form below. FEE $35.00 per month
( if your friends are planning on taking next year please have them call now so I can save them a spot )
FYI: Classes may be taught by Brenda or her children.
FALL CLASSES WILL RESUME in AUGUST 24, 2009 WHEN SCHOOL STARTS!

REGISTER (name) ____________________________FOR (circle) Fall Dance Fall Tumbling Fall Clog Summer Tumbling

REGISTER (name) ____________________________FOR (circle) Fall Dance Fall Tumbling Fall Clog Summer Tumbling

Summer tumbling clinics: $35.00 each (circle clinic you want to register for) Time: 3:45-4:45
#1- JUNE 7-11 #2- July 5-9 #3- AUGUST 9-13

Consent and Authorization and Release of Liability
Name(s) ________________________________________________________________________
Age(s) __________________________________________________________________________
Grade(s) in School________________________________________________________________
Date(s) of Birth___________________________________________________________________
E-mail address-______________________________________________
Phone #__________________________________Emergency Phone #_______________________
Home Address________________________________City/St___________________Zip________
I give my consent for the above named participant(s) to participate in Dance and/or Tumbling taught and designed by Brenda Larsen. I hereby agree to release and indemnify Brenda Larsen and her family from any Liability, Claim, Injury or Damage of whatever kind or nature resulting in their participation in the above described activity. I also authorize Brenda Larsen to arrange and authorize emergency treatment for any accident or illness that might occur while the above named participant(s) is (are) participating in the described activity or traveling with Brenda Larsen to and from specified activities as well.

Signature of Parent or guardian______________________________________date________________
______Please check if you need a new Brenda’s Shirt and Circle sizes : CM CL AS AM AL AXL

fun

Thursday Pictures: MM sold separate for $12*- March 11 Thursday, PICTURE DAY -

A Package w/MMate - $30
1-8x10
2-5x7
8-wallets

B Package w/MMate - $27
2-5x7
8-walletts

C Package w/MMate - $24
2-4x6
4-wallets

2010 PICTURE DAY SCHEDULE on Thursday, March 11 … here at the dance studio.
.(we will not dance Thursday but we will have classes the rest of the week )
-Note: you can wear your hair in your favorite style for the pictures!
-Note: WE WILL NOT WAIT FOR YOU….PLEASE BE on Time. There is only 15-20 min per class!
-Note: You must pay for the photos at time of ordering. Reorders by special arrangement but double the price
Can do family pics on the 10th evening too......to schedule please call Brenda
Thursday Pictures:
Class ……………………………..PICTURE TIME on Thursday

Tuesday at 9:15………………………………. 10:00-Jade

Monday at 9:15……………………………….. 3:40-light pink
Tuesday 3:45 dance……. ………………………4:00-red

Wednesday 3:45 dance ……………………...….4:30-yellow
4:15 family pic- Wilcox
Wednesday 4:45 dance………………………….4:45-hot pink
Thursday 3:45 dance class………………………5:00-purple
Thursday 4:45 tumbling class …………………...5:30-silver

Fri 3:45 Tumbling Class ………………….…..…5:45 -black
Monday 3:45 Tumbling class………………..… 6:00 -red
Tuesday 4:45 dance …………………….. …..6:15 -multi-CHANGED)
Moms Mon and Tues class……………………....6:30-vests

Thurs 5:45 clog………… …………..……….….6:40 -blue
Monday 4:45clog class……………………….. 7:00 green or orange
Monday 5:45 clog class and sr solos……………7:20 - red plad
Larsen Fam-8:00
Petersen- 8:15
Fyke Family-8:30
Family pictures can be scheduled…………….8:00 to ?

March 11-…Registration for summer and fall classes for next year.
Please fill reg form out on picture day to save your place, thanks!

March pmt- $10.00 review fee due
Spring break Mar 29-April2
Logandale fair – April 10@ 5:00
Heritage days parade- April 17 @ 9:30
Henderson Conv – May 23 @2:00
Dance review Friday May 28@ 6:30
Swim Party and BBQ- June 5???