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Student Name
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Age
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Parent Name
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Address
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City
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State
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Email
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Phone
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Camps*
Pre-Ballet Summer Intensive I Ages 6 to 7 or completion of Pre-Ballet I June 13 to 16, 9 a.m. to 12 p.m. ($250)
Ballet 1 Summer Intensive I Ages 7 to 8 or completion of Ballet 1 I June 27 to 30, 9 a.m. to 12 p.m. ($250)
Ballet 2 Summer Intensive I Ages 8 to 9 or completion of Ballet 2 I June 20 to 23, 9 a.m. to 12 p.m. ($275)
Ballet 3 Summer Intensive I Ages 9 to 13 (current Ballet 3 Students) I June 20 to 30, 1 to 4 p.m. ($425)
Intermediate and Advanced Dance Intensive I Ages 13 and up I June 13 to 16, 1 to 4 p.m. ($275)
Intermediate and Advanced Nutcracker Prep I Ages 13 and up I August 2-5 I 10 a.m.-2 p.m. ($275)
Musical Theater Dance Intensive I Ages 8 and up I July 18-21 I 10 a.m.-2 p.m. ($225)
Release of Liability*
I hereby release Buckman Fine Arts Center, St. Mary’s Episcopal School, Mandy Possel, Steven Prince Tate, and Cindi Younker of any liability for accidental injury caused by acts of self or other students attending these dance classes, rehearsals and performances. The undersigned expressly consents to acceptance of all responsibility for any injuries that might occur. Additionally, the Buckman Dance Conservatory has my consent to publish any photos taken of student. Classes meet in the dance studio of Buckman Arts Center. See buckmanartscenter.com for details.
I Agree to the Release of Liability above.*
TOTAL PAYMENT
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Please send a confirmation email to the address below*: