Pacific Coast Dance Fest 2008

Registration

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About Me

• Name e.g. John Smith
• Address
• City
• State --- Please select --- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming
• Zip
• Phone e.g. 123-456-7890
• Email
• Date of Birth e.g. 12/25/1992
• Age as of July 2008
• Adult t-shirt size --- Please select --- S M L XL

About My Studio

• Studio Name
• Phone e.g. 123-456-7890
• Address

My Dance Camp

• I can't wait to join: Minnesota Session, August 2-8, 2008
•   California Session, August 10-16, 2008

• I would like to room with: (Roommate requests must match.)

  Choice 1
• Choice 2

My Emergency Contact

• Mother's Name
• Father's Name
• Parents Work Phone

• Whom student may be released to in case of emergency and parents cannot be reached.

  Name
• Relationship
• Address
• City
• State --- Please select --- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming
• Zip
• Phone e.g. 123-456-7890

• I authorize any licensed physician to render necessary emergency treatment for injury or serious illness when neither parent can be reached and will assume all financial responsibility for such treatment. I authorize Pacific Coast Dance Fest to choose a physician in case of emergency.

  I authorize the statement above.

List anything that would prohibit you from participating in all dance classes. Also, list all previous dance/athletic related injuries with dates injured.

My Agreement

Student Behavioral Contract

In order to assure all students a positive learning experience, it is important that the following rules of respect and courtesy are maintained.

1. Listen and obey instructions at all times.
2. Be respectful of fellow students in both action and language
3. Be prompt and enthusiastically participate
4. For dancers' protection, this is a closed campus. I may not leave the camp under any circumstances.
5. PCDF is a drug/alcohol/tobacco free environment. Anyone caught in possession of, or using these substances will be sent home immediately at the parents expense.

Should there be a problem with any of the above expectations, the following consequences will occur:

1st offense: Verbal warning

2nd offense: Parents will be contacted by phone and student will meet with camp staff prior to being allowed to return to workshop.

3rd offense: Student will not be permitted to participate in the workshop and student will be sent home at parent/guardian's expense.

• I agree with the contract above.