Dupont Manual Dance team Clinic

If anyone is interested just send me email or leave me a message here and I will pick up your entry forms

2003-04 and 2005-06 NDA National Champions
The Manual Dazzlers
Presents:

DANCE DAZE
2007

Dance Clinic
Saturday, September 15, 2007
9 a.m. – 2 p.m.

DuPont Manual High School
Cost: $30.00 per dancer

The Dupont Manual Dance Team “The Dazzlers”
will offer a dance clinic from 9 a.m. to 2 p.m. Saturday, September 14, 2007. Participants will learn a dance routine that they will perform during halftime of the September 21, 2007 football game.

$30 includes: clinic fee, lunch, beverages, door prizes, goodie bags,
and a t-shirt

Return around 1:30 to watch your child perform their routine

Entry Form

Dancers Name: ________________________________ Age: _______________

Parent or Guardian Name: ______________________________________________________

Phone numbers: ____________________ Cell: ____________________________________

Address: __________________________________________ City/State/Zip______________



T-shirt size: Child sm___ med___ lg___
Adult sm___ med___ lg___


Please try to register early so that t-shirts may be ordered.
However, registration will be accepted at the door.

For more information contact
Teresa St.Clair at 363-5636 or after 7:00 p.m. 262-2550


Manual Dazzler Dance Clinic Waiver Form

Dancer Name_________________ Parent Signature________________________

Please fill out each line completely with all insurance information and signatures.

Mail completed forms and checks to:
Manual Dazzler Booster Club
Dance Clinic
2205 Stephan Lane, Lou, KY 40214

I, the undersigned parent/guardian of the participant listed below, do hereby giver permission for him/her to attend and participate in the Manual Dance Daze Dance Clinic. I understand that by attending and participating in this event, there is a possibility of physical illness or injury to her/him. I hereby waive, release and forever discharge any and all rights and claims for damages which may arise against the Manual Dance Boosters. Furthermore, I authorize the directors of the Manual Dance Daze to act for me, according to their judgment in any emergency requiring medial attention.


I certify that I have medical insurance on my child that will provide coverage while he/she participates in the Manual Dance Daze Clinic.



Name of Participant Insurance Co Name Policy # Signature of Guardian



________________________ __________________________ ____________ ____________________