Download Report

Girls & Boys
July 20-22
Ages: 4 -12
9 a.m. - Noon
Eleazer Arena // Newberry College // Newberry, S.C.
Camp Details *NEW FOR 2015!*
Each day of camp will be a different fun theme and dancers are highly encouraged to
dress-up!
Monday
Tuesday
Wednesday
Prince &
Princess
Rodeo
Round-Up
Hawaiian
Luau
About The Camp
The Newberry College Dance Camp is designed to build a foundation of basic dance skills in a
positive and fun atmosphere. The camp will focus on providing campers with the necessary technique
to become a successful dancer. Participants will be taught a basic dance routine similar to those
seen on gameday, as well as participate in various fun team building activities! Campers will have the
opportunity to showcase their skills in a performance on the final day of camp (12 p.m.).
Registration Information
Cost: $50 (Includes T-Shirt & Snacks)
Make checks payable to: Newberry Dance Camp
Please email any questions to head coach, Jenna Eyre:
jenna.eyre@newberry.edu
Camp Participant Name:______________________________________
T-Shirt Size (circle one): Youth Small
Adult Small
Youth Medium
Adult Medium
Date of Birth:__________
Youth Large
Adult Large
Adult XL
Parent/Guardian Name (Print): ________________________________________________________
Address:____________________________________________ City:______________ State:______
Contact Phone Number: (______) - _______ - ___________
(over)
Email:________________________
2015 Medical Release of Liability and Camp Waiver Agreement
In consideration for my child being permitted to participate in the Newberry Dance Camp, related events and activities,
the undersigned acknowledge and agrees that as the natural parent and/or as the legally authorized guardian, do hereby
for myself, and on behalf of my/our heirs, personal representatives, and assigns, agree not to sue and hereby release,
waive, discharge, hold harmless and indemnify and forever defend Newberry College, its members of the Board of
Trustees, the Newberry College Athletics Department, individually and collectively, its officers, employees, servants,
agents, and directors, from any and all liability, losses, claims, actions, suits, procedures, demands, rights, and causes of
action of whatever nature, in law and equity, for any and all known or unknown, foreseen or unforeseen, bodily or personal
injuries, death and permanent injury, illnesses, damage to property, or other losses, and any consequences thereof,
including expenses, costs, and attorney’s fees, as may be sustained by my child or me arising out of or in any way
associated with my child’s participation in the Newberry Dance Camp, or travel incident there to, whether by negligence or
not to the fullest extent permitted by law.
The risk of serious injury to my child from these camp activities does exist including the potential for permanent
disability and death. I understand and fully acknowledge that my child’s participation in these activities is solely at our own
risk and I assume full responsibility. I hereby further declare that my child has had a physical examination within the past
one (1) year and is physically able to participate in all camp activities.
Moreover, I hereby understand and affirm that the camp only provides for excess medical insurance and any charges
including deductibles related to the medical care provided to my child will be the responsibility of my primary insurance
carrier or me.
The Newberry Dance Camp is open to any and all entrants, limited only by number, age, grade level and/or gender.
If deposit is required, a refund may be provided one (1) week prior to start date. For all balances due at registration, no
refund is provided for days absent or any part of the day missed once payment is received.
MAIL COMPLETED REGISTRATION & FEE TO:
Jenna Eyre
Newberry College Athletics Scarlet Poms
2100 College Street
Newberry, SC 29108
I HAVE CAREFULLY REVIEWED AND VOLUNTARILY AGREE TO THE TERMS OF THIS CAMP WAIVER AND RELEASE OF LIABILITY AGREEMENT.
Camp Participant Name:______________________________________
Date:________________
Parent/Guardian Name (Print): ________________________________________________________
Parent/Guardian Signature:___________________________________________________________
Insurance Co:____________________________
Policy #: ________________________________
Allergies:________________________________
Physician’s Name:_________________________
Number:_________________________________
Special Instructions:_______________________