Trojan Belles Dance Intensive
For dancers in grades 6th-10th
Camper Information
Name
*
First Name
Last Name
Grade Level
*
Please Select
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Camper's School
*
Camper's TShirt Size
*
Please Select
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult Extra Large
Adult Extra Extra Large
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Parent/Guardian Information
Name
*
First Name
Last Name
Relationship to Camper
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Emergency contact is the same as Parent/Guardian Information
*
Yes, please contact the above listed parent/guardian if there is an emergency
No, I would like to put someone else down as an emergency contact
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Emergency Contact Information
Emergency Contact's Name
First Name
Last Name
Relationship to Camper
Phone Number
Please enter a valid phone number.
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Terms & Conditions
Check to agree with the following terms: I, the parent/guardian of the camper associated with this registration, do hereby acknowledge and grant permission for my child or children listed above to participate fully and without restriction in the physical activities of the clinic identified above. On behalf of my heirs and assigns, I hereby release, indemnify and waive any and all claims I may or may not have against Anderson High School, the Trojan Belles, the dance directors and any parent or student instructors participating in the instruction or implementation of the dance clinic or camp, from any claims, physical and emotional, including bodily injury or illness that may be sustained in connection with attending the camp and with participation in any and/or all camp activities. I hereby give my permission to the Clinic Director to provide and/or seek medical attention or treatment that may be deemed necessary to insure the well-being of the named child. The director will attempt to contact me prior to administering/ seeking non-emergency medical attention.
*
I agree to all terms stated above
COVID-19 has been declared a worldwide pandemic by the World Health Organization. COVID-19, is extremely contagious, and is believed to spread mainly from person-to-person contact. Austin Independent School District(AISD) has put in place protective measures to protect the spread of COVID-19 and is following Texas EducationAgency (TEA) and University Interscholastic League (UIL) guidelines; however, AISD cannot guarantee that you, your child, or close contacts will not become infected with COVID-19. Further, attending/participating in extra-curricular activities could increase the risk of contracting COVID-19 not only to the student but also the student’s household. Extra-curricular activities including UIL activities are voluntary activities.I acknowledge that my child’s participation in extracurricular activities, including but not limited to UIL activities,(hereafter extra-curricular activities including UIL activities are the “Activities”) is voluntary. I acknowledge the contagious nature of COVID-19, and on behalf of myself and my child, I voluntarily assume the risk that my child, and I, and any member of my family/close contact may be exposed to or infected with COVID-19 by participating in Activities and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I acknowledge that I am being advised my child should practice physical distancing and wearing of a mask while at home to protect family members. I understand that the risk of becoming exposed toor infected by COVID-19 while attending/participating in Activities may result from the actions or omissions of myself and/or others, including, but not limited to AISD employees, agents and representatives, volunteers, participants and their families and/or any other individual who may be present or in attendance.I voluntarily agree to assume, on behalf of myself and my child, all risks and accept sole responsibility for any injury to my child, myself and any member of my family (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I, my child and/or members of my family may experience or incur in connection with my child’s participation in the Activities.With full awareness and appreciation of the risks involved, I, as the parent/guardian, hereby forever release, waive, discharge, and covenant not to sue Austin Independent School District, its board members, officers, agents, servants, independent contractors, affiliates, employees, successors and assigns(collectively the “Released Parties”) from any and all liability, claims, demands, actions, and causes of action whatsoever, directly or indirectly arising out of or related to any loss, damage, or injury, including death, that may be sustained by me or my child(ren) related to COVID-19 or other injury/disease whether caused by the acts, omissions, and/or negligence of the Released Parties, any third-party using AISD facilities, or otherwise, while participating in any activity while in, on, or around AISD facilities, and/or Activities, and/or while using any AISD facilities, tools, equipment, or materials. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of AISD, its board members, officers, employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in Activity.Additionally, the laws of the State of Texas provide immunities for school districts and employees and agents. In addition to this Agreement, these immunities remain intact and are not altered or waived in any manner.
*
I agree to all terms stated above
I give the Trojan Belle director and dance clinic volunteers or other designated personnel permission to photograph my child during the dance clinic for media publications, flyers, video presentations, yearbook and web page material that promotes the Trojan Belles.
*
I agree to all terms stated above
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Food Allergies & Check-In/Check-Out
We will be serving a daily snack & a pizza dinner on the last day. Each camper is responsible for providing their own nonperishable lunch each day. Please identify any medical limitations or allergies your child may have that the camp needs to be aware of (including allergies to medications and foods).
Please indicate below whether or not your camper has permission to check themselves in and out each day at camp.
YES, my 6-10th grade camper has permission to check himself/herself in and out.
NO, my 6-10th grade camper does NOT have permission to check himself/herself in and out.
Is there anything else we should know about your child?
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Paying Online via PayPal
Camp Fee
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Camp Fee
If you are an Anderson High School teacher, please use the coupon code distributed via email.
$
165.00
Payment Methods
Debit or Credit Card
Please click one of the PayPal options to complete payment and
submit
the form.
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