Summer Camp

SARA RAYMOND DANCE ACADEMY

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Summer Camps 2022

Registration Form Summer Camp Ages 5 - 10yrs

* Indicates required field

Name *

First

Last

Parent/Guardian *

First

Last

Phone Number *

Email *

Medical Conditions/Allergies? *

Camp I Would Like To Register For *

July 11- July 14 Ballet & Jazz 9am-12pm July 11 - July 14 Hip Hop & Contemporary 12:15-3:15pm August 15 - 18 Ballet & Jazz 9am-12pm August 15 - 18 Hip Hop & Contemporary 12:15-3:15pm

Payment (due upon registration) *

Online Credit Card E-transfer

There are no refunds once fully registered in the program. *

Yes

I understand that if the dancer is not feeling well that they must miss their dance class until once feeling better. * *

Yes

I hereby release and forever discharge Sara Raymond Dance Academy, its Directors, Employees, or Volunteers and its or their successors, of and from any claim, demand, damage, which may include a failure to properly safeguard against any dangers and hazards pertaining to the event, including, without limitation, the negligence of the agents, employees and instructors working with/for Sara Raymond Dance Academy. * *

Yes

I hereby authorize the owner of Sara Raymond Dance Academy, the employees, volunteers, and subcontractors to medically assist your child. * *

Yes

I certify that I am the legal guardian of the minor child that I have registered, or that I am the age of majority. I have read the terms and conditions and am bound to them. * *

Yes

We the guarantor, if applicable, on behalf of ourselves, members of our family, hereby forever release, discharge and hold harmless members of Sara Raymond Dance for any injury arising out or in connection to taking dance class. * *

Yes

Comment *

Submit

Summer Camps 2022

Registration Form Summer Camp Ages 5 - 10yrs

204- 6750 N Island Hwy in North Nanaimo