The NRHS Dance Team Proudly Presents:

The Fourth Future Dance Mini-Camp & Performance

Date of Clinic: Saturday, December 14, 2013

Place: NRHS Back Gym

Time: 10am-12pm

Date of Performance: December 20, 2013

Place of Performance: NRHS Main Gym

Time of Performance: ~7:30pm

*More information will be given on the day of the clinic*

Amount: $25.00 per girl (includes T-shirt & Hair Ribbon)

(Checks can be made payable to North Ridgeville High School)

*Instruction will be provided by the North Ridgeville Dance Team

*Participants will get to perform during the December 20th Basketball Game Halftime after watching the Dance Team perform their Holiday Kickline. Exact information about the performance will be handed out to each participant at the clinic. Parents should pick their daughter up after the performance at North Ridgeville High School. If you have any questions, please contact Ms. Allison Kocheff at (440) 327-1992 or (Best option).

------

Name: ______Grade: ______ School: ______

Tee-Shirt Size (Circle One): YXS YS YM YL YXL AXS AS AM AL AXL

Parent/Guardian Name: ______

Phone: ______Parent E-mail (In case there are Changes): ______

*Any allergies/medication: ______

*Please send registration form and money by November 25th to:

Allison Kocheff (Dance Coach)

c/o North Ridgeville High School

34600 Bainbridge Rd.

North Ridgeville, OH 44039

*Please note all payments are final. There will be no refunds once tee-shirts are ordered.*

*We, herby acknowledge that we have been properly advised, cautioned and warned by the proper administration and/or coaching personnel of North Ridgeville City Schools, that by participation in athletics, an athlete may suffer serious injury. These injuries may include, but are not limited to: sprains, fractures, ligament and/or cartilage damage, which would result in temporary or permanent, partial, or complete impairment in the use of limbs, participation in this activity, it is our desire to give consent for participation.

*PHOTO RELEASE: I hereby give permission to photograph/video my child- by newspaper, media staff, or NRHS Dance Coach.

Parent signature: ______Date: ______