OTM Summer Technique - On the Move Dance Studio

Summer Technique Classes
We will be offering two different summer sessions for technique in a little different format this year. This is an excellent
class for older dancers who want to work on their dance technique, leaps, turns, flexibility, etc. Session 1 will be a twoday intensive on June 12th and 13th from 9:30 – 12 and will include stretching, conditioning, and technique. The cost for
Session 1’s intensive is $70. Session 2 will June 29, 30, July 1st, and 2nd. We will have a class for 7th grade and up from
10-11:00 and a class for 4th-6th grade from 11-12:00. The cost for Session 2 is $60.00
Session 1 $70
6th grade and up
June 12 & 13, 9:30 - 12
Dancer’s Name: ___________________________________
Session 2 $60
7th Grade & Up: 10am
4th – 6th Grade: 11am
June 29, 30, July 1, 2
Age: ___________
Grade going into:
Parent’s Names:_____________________________ Emergency Contact: ______________________________________
Address: ______________________________________________________
Email: ____________________________________
Phone numbers:
_____________ ____________
___________________________________
Please order my child a 2015 Dance Camp T-shirt for an additional $10 (circle size) YXS YS YM YL AS AM AL AXL
Order deadline for a guaranteed camp shirt is Friday, July 3rd
DANCE CONSENT FORM & IMAGE USAGE AUTHORIZATION
In consideration of my child’s participation in the classes given by On The Move Dance, LLC I do herby
for my child release and discharge Kari May and all personnel thereof for all claims or damages, demands,
actions, or whatsoever in any manner arising or growing out of my child’s participation in any of the
classes offered by OTM Dance. I attest and verify that I have full knowledge of the risks involved in
exercise and my child is physically fit and able to participate without endangering my child’s health.
Also, I hereby grant permission to On the Move Dance, LLC to use the image(s) of my child(ren). Such
use includes the display, distribution, publication, transmission, or otherwise use of photographs, images,
and/or video taken of my child for use in promotional, marketing or educational materials.
I agree that these images may be used by On the Move Dance, LLC without further notification. I do
understand that my child(ren)’s last name will not be used in conjunction with video or digital images.
Signature-Parent or Legal Guardian
Date