David Crockett HS Tex-Anns

David Crockett HS Tex-Anns

Present the 2015 Tex-Ann Dance Clinic

Ages 4-14

When: December 5th, 2015

Registration: 8:00am

Clinic: 8:30am-2:00pm

Performance: 1:30pm-2:00pm

(Show-off for family and friends)

Where: Crockett High School

Main Gym

5601 Manchaca Rd

Austin, TX 78745

What is Included: Crockett Tex-Anns will instruct the participants in basic dance technique. Each age group will participate in icebreaker activities and prepare a performance routine for our concluding show. Each camper will receive a winter dance clinic t-shirt.

What to bring: 1.) A parent to register camper between 8:00am-8:30am

2.) Sack lunch, water and snacks

3.) Proper attire consisting of athletic clothing and tennis shoes

4.) Attached Emergency Contact Release Form

What’s the cost: Payment received:

Before December 5th- $30.00

Day of clinic- $35

Crockett staff- $25 - Contact Mrs. J in advance for this price

For more info call: Ginger Jarosek, Tex-Ann Director @ 512-414-7832

Email:

Parents: Please fill out the form and return with payment to: Crockett Tex-Anns

5601 Manchaca Rd, Austin, TX 78745 Attn: Ginger Jarosek

Please pre-register my child for the Dance Clinic (Checks payable to: Crockett H.S. Tex-Anns)

Name: ______Age: ______Grade: ______

Address: ______Phone: ______

Emergency #: ______Cell #: ______

School: ______Teacher Name: ______

T-Shirt Size (Please circle your child’s size):

Youth S(6-8) Youth M(10-12) Youth L(14-16) Adult Sm Adult Med Adult Lg

Sponsoring Tex-Ann: ______

Crockett High School Tex-Ann Dance Clinic

Emergency Contact & Release Form

***Please Fill Out Completely & Turn in during

Registration Time on Day of the Clinic***

Student Full Name: ______

Date of Birth: ______Age: ______

School: ______Grade Level: ______

Parent Full Name: ______

Home Phone: ______Emergency Phone: ______

Address: ______

Alternate Emergency Contact: ______

Please write and explain any medical conditions or health concerns that we may need to be aware of: ______

______

Each participant’s parent must sign the following release for the student to participate in the Tex-Ann Dance Clinic.

·  Student must abide all Austin ISD and Crockett High School Rules and Regulations

·  I understand that by my child taking part in this clinic, there is a possibility of injury or illness, and I knowingly and freely assume all such risks and agree to hold harmless the Tex-Ann Dance Clinic and its staff, and Crockett High School,

·  I do hereby grant permission to hospital staff to administer immediate treatment to my child should he/she be injured and require emergency medical attention.

·  I give the Tex-Ann Dance Clinic the right and permission to film, photograph, or videotape my child for reproductions associated with the Tex-Ann Dance Clinic.

Signature of Parent/Guardian:

______Date: ______