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*NEW RATES FOR FALL 2011*
Prices are based on MONTHLY payments. $50 per dancer, and then $30 for each additional class.
PAYMENTS are to be paid MONTHLY and no later than the 5th of every month. With checks made payable to HOLY ROSARY SCHOOL. All classes are held in the Holy Rosary Parish Center Reception Room.
* If you have a special circumstance or have questions on your bill, please let me know!
SunDance Fall Dance Session REGISTRATION FORM
Name of Child: ___________________________________ Age: _____ Grade: ______ School:
_____________________________________________________
Parents Name:
_______________________________________________
Home phone: ________________________ Cell phone:
________________________
Address: _____________________________ City _________________ State ____ Zip
______ Email Address: (please print
clearly) _________________________________________
I, ______________________________ am allowing my child,
___________________ to participate in the SunDance Fall Dance Sessions. I understand that with any athletic activity,
including dance, that accidents happen. In the event of an accident, I release
SunDance Fall Dance Session, and its instructors Dawn Holmes and Angel
Sorensen, as well as Holy Rosary School from any and all liability. I understand
that my child will be taught in safe progressions however there is always a
risk involved with this type of activity.
Parent/Guardian Signature:
____________________________________
Date: ___________________
Payment: Check #
____________ Amount #
_____________
OR PAY ONLINE ON THE HOLY ROSARY WEBSITE: CLICK "DANCE"
Circle Sessions your child will attend:
Mondays :
Jazz I 3:15-4:15pm
Jazz II 4:15-5:15pm
Wednesdays :
Hip Hop I :
2:45-3:45pm
Hip Hop II :
3:45-4:45pm
Thursdays :
Private/Small Group
: 3:00-3:30pm
Preschool :
3:30-4:20pm
Fridays :
The CREW :
3:15-4:15pm
*NEW* OPEN Hip Hop : 4:15-5:15pm
*BASE* (circle if applicable)
· My child is a part of the Holy Rosary BASE
program, please sign my child in and out accordingly.
Confirmation of registration will
be sent via email once reservation is received. Payments are due at time of
your child’s first class or by the 5th of every month. You may turn paperwork in on first day of
class OR mail registration form, information release, insurance info and Dawn Holmes, 10045 42nd AVE SW, Seattle,
WA 98146.
Contact Dawn Holmes or Angel Sorensen at sun_goddess22@hotmail.com, with any
questions. CHECKS PAYABLE TO HOLY ROSARY SCHOOL.
2011 SunDance Fall
Dance Session Emergency Information
Emergency Contact Names/ Relationship to Camper/ Phone
Number
1.Name
__________________________Relationship_____________
Phone
Numbers_________________
2.Name__________________________
Relationship_____________
Phone Numbers_________________
3.Name__________________________
Relationship_____________
Phone
Numbers_________________
List of all
allergies/reactions __________________________________________________________________________
__________________________________________________________________________
Past Illness, Injuries, Special
Needs __________________________________________________________________________
__________________________________________________________________________
Physician’s Name __________________________
Phone Number __________________________
Consent Form for Photography
I, , allow
my child, ,
to be photographed, and do agree that his/her image
may be used on the SunDance Fall Dance
Session website, posters, programs, newsletters, newspapers and any other
publicity materials used by SunDance Fall Dance Session.
Parent/Guardian Signature : .
Date :
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