Dakota Spirit Classes for June, 2015 Add $5 if not registered 48 hours prior to class Monday Classes June, 1, 8, 15, 22 Beginner Basics (Intro to fundamentals) Level 1 Beginners 1 Level 2 Advanced Beginners 2 Level 3 Intermediate (Instructor approved) Level 4 Advanced (Instructor approved) Level 5 Elite (Instructor approved) Tuesday Classes Moms & Tots -NEW June 2, 9, 16, 23 10:000-10:50 am Cheer University 5:30-6:15 pm Hip Hop 6:15-7:00 pm Combo – Cheer University and Hip Hop TIME 4:15-5:15pm 4:15-5:15pm 5:15-6:15pm 6:15-7:15pm 7:15-8:15pm 8:15-9:15pm AGES 5-10 5 & up 6 & up 6 & up 10 & up 10 & up COST $53.50 $53.50 $53.50 $53.50 $53.50 $53.50 COST (6mo and under – no charge) AGES Ages 6 mo to 4-1/2 $9 – 1st class/$7 – 2nd class/$5-siblings Ages 5 & up Ages 5 & up Ages 5 & up $39.25 $39.25 $68.00 Wednesday Classes June 3, 10, 17, 24 AGES Little Sizzlers Tumbling Class 5:30-6:15pm Ages 2 ½-4 Beginners 1 & 2 5:30-6:30pm Ages 5 & up Power Tumbling 7:15-8:30pm Ages 6 & up Flexibility & Flyers 6:30-7:30pm Ages 6 & up *Special “Combo rate” for Flex Flyers and Power Tumbling - $80 Thursday Classes Beginners Level 1 & 2 June 4, 11, 18, 25 4:30-5:30pm AGES Ages 6 & up Friday Classes June 5, 12, 19, 26 Friday Night Lights! Supervised Open Gym! (cash/check at door) Wavier required on first visit. AGES Saturday Class Level 1-3 AGES Ages 5 & up June 6, 13, 20, 27 9:30-10:30am **Wednesdays – June 3, 10, 17, 24 Hit It “N Git It Conditioning Hit It “N Git It Conditioning 7:00-9:00 COST $53.50 $53.50 $48.50 $39.25 COST $53.50 COST $7 members $10 non-members COST $53.50 and/or **Fridays – June 5, 12, 19, 26 8:30-9:30 am 9:30-10:30 am Ages 12 and up Ages 6 and up $53.50 $53.50 *If you register early for both Wednesdays & Fridays Hit It during June – special cost of $90. Make sure to indicate days on registration form Payment Info - Class Discount: Preregistration Only Sibling Discount - Sign up for a $53.50 priced class with a sibling, sibling gets $10 class discount – total due $97 Take two $53.50 classes during month, discount is 10% off 2nd class. (Total due $101.65) (Not Hit It & Git It) Friday Night Lights is “drop in” & no preregistration or prepayment is required. Waiver due at first visit. Small Groups & Private Lessons: Please contact us to set up a private, semi private or Small Group Lesson for Tumbling or Stunting Sessions. Make Up Class: We will allow one make up for the session. Pls prearrange with Coach Jay We do not prorate classes if you cannot make all classes in session. Class size is limited. We can recommend which class is suitable for your child. Please contact us. Dakota Spirit - ONE TEAM, ONE SPIRIT ©Dakota Spirit, LLC 05/07 DAKOTA SPIRIT, LLC - Student Class Registration Information Please complete and return (DS Team members need only complete top half of page.) Student’s Name _________________________ Age ______ Date of Birth ________ Phone: ______________ Parent/Guardian Name _____________________ Email: ________________________Team _____________ Address____________________________________ City ________________State_______ Zip___________ CLASSES you are registering for: _________________ DAY(s) you are registering for: __________________ MONTH _____________ DATES(2) _____________TIME(s) you are registering for: _____________________ Add $5 if not registered 48 hours prior to class!! * Sibling Discount - Sign up for a $53.50 priced class with a sibling, sibling gets $10 class discount – total due $97 * Take two $53.50 classes during month, discount is 10% off 2 nd class. (Total due $101.65) (Not Hit It & Git It) Non- member registration fee $20.00 (one-time yearly fee) For Student Scholarships/Connecting Kids – You must pay the $20 non member fee, take two classes, and attach Connecting Kids certificate/Tuition Assistance form. Conn Kids will pay cost of one class during the calendar year/matched by Dakota Spirit. Please complete Student Information if you have not participated in the past 6 months (see below) If you have questions about the appropriate class for your child’s skill level, contact our office, 373-0414 Payment: Check Check Number________ Make checks payable to Dakota Spirit Cash - Amount $___________ PayPal (your DS account will be charged the 2.9% processing fee plus .30¢) Make payment at Paypal@dakotaspirit.com Credit Card-Manual Entry - add 3.5% plus .15¢ to total amount due Card Type: ___________ CC # _______________________ Exp. Date: ________ CVV: _______ Zip: ___________ Please mail forms/payments to: Dakota Spirit, 3910 W 59th St, Sioux Falls, SD 57108 Gym is open most evenings if you prefer to drop off – please place in lower lock box in the gym lobby. YOU MUST INCLUDE PAYMENT WITH FORM ------------------------------------------------------------------------------------------------------------------------------------------------------------STUDENT INFORMATION Family Doctor’s Name ______________ Doctor’s Phone Number ____________ Allergies _______________________ Please list all current & previous illness or injuries: _______________________________________________________ Current or past medical history: ______________________________________________________________________ 1. I, _____________________, legal guardian/parent fully understand that I am responsible for payment of expenses incurred relating to my child’s medical treatment as a participant in the activities of Dakota Spirit, LLC. 2. I certify that Minor is physically capable and has no previous injuries that will affect participation in Dakota Spirit, LLC. 3. I hereby have been forewarned that participation in Dakota Spirit has the following non-exhaustive list of particular risks and injuries including but not limited to: sprains, strains, abrasions, dislocations, fractures, concussion, contusions, blisters, head and neck injuries, illness, and possible death. 4. Having been forewarned, I assume all risk and full responsibility in connection with Dakota Spirit and hereby release all instructors, staff, volunteers, practice and performance facilities, and others involved with Dakota Spirit from any injury that may befall my child. I am willing to accept these risks to participants of Dakota Spirit. 5. I understand that Dakota Spirit strives to provide the maximum in safety precaution & student training. 6. I give permission for any medical treatment necessary in the event of illness or injury at any event we participate in with Dakota Spirit. This includes emergency transportation. 7. I fully accept and assume all risks and all responsibility for losses, cost, and damages I incur as a result of my participation in the Activity. 8. I the minor’s parent and/or legal guardian, understand the nature of the above referenced activities and the Minor’s experience and capabilities and believe the minor to be qualified to participate in such activity 9. I hereby release, discharge, and covenant not to sue Dakota Spirit, LLC, its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place (each considered one of the “RELEASEES” herein, from all liability, claims, demands, losses, or damages, on my account caused or alleged to be caused in whole or in part by the negligence of, but not limited to, administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors including negligent rescue operations and future agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releases, I will indemnify, save, and hold harmless each of the Releases from any loss, liability, damage, or cost, which any may incur as the result of such claim. 10. I grant permission for my child to be photographed, videotaped, or interviewed for the website, publications or press. ________________________________________________ Signature of Parent/or Legal Guardian _______________________ ________________ Phone Number Date EMERGENCY CONTACT: Name__________________ Relationship __________ Phone Number____________ Dakota Spirit - ONE TEAM, ONE SPIRIT ©Dakota Spirit, LLC 05/07
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