JUNE 27TH - JULY 1ST
8:30 AM - 12:30 PM

PRE-K - 8TH GRADE
$40.00

Breakfast and Lunch Included
Camp Located at St. Joseph School on Brooklyn Avenue

JOIN US FOR FIVE FUN-FILLED DAYS AT OUR 2016 SUMMER DANCE CAMP! THROUGH THE COURSE OF THE WEEK, STUDENTS WILL LEARN A VARIETY OF DANCE ROUTINES, AND PARENTS AND FRIENDS ARE INVITED TO WATCH THE CAMPERS PERFORM ON FRIDAY, JULY 1ST AT 11:30 AM!  EACH CAMPER WILL RECEIVE A T-SHIRT!  ON THURSDAY, CAMPERS WILL ALSO EXPERIENCE A FUN & FASCINATING DAY OF BEE EDUCATION WITH THE SOUTHWEST HONEY COMPANY!  
BOYS AND GIRLS WELCOME!

8:30 AM BREAKFAST ARRIVAL - DOOR 2
12:30 CAMPER PICK-UP - DOOR 2

REGISTRATION

Student Name *
Student Name
Grade entering in the 2016-2017 school year
Address *
Address
Parent/Guardian Name *
Parent/Guardian Name
Parent Home Phone *
Parent Home Phone
Parent Cell Phone *
Parent Cell Phone
Registration Terms & Conditions *
I understand it is my responsibility to inform the instructors of any restrictions I (my child) have. (i.e., knee, back, blood pressure, asthma, etc., medication I am taking, or if I am under a doctor’s care.) In consideration of the services to be provided hereunder, I agree on behalf of myself, my child (the student if applicable) jointly and severally, and our heirs, representatives, executors, successors and assigns, to save and hold Triple Threat Performing Arts Academy and St. Joseph School and all staff (“Company”), harmless from and against any and all costs, losses, liabilities, obligations, damages, lawsuits, deficiencies, claims, demands, and expenses, and to forever release and discharge the Company from any and all claims, causes of action of any type, whether matured or unmatured, absolute or conditional, known or unknown, in the past, present or future, in any way arising out of, or related to the relationship between the Company, myself, or my child (the student if applicable). I understand and agree that the Company may use images of me (my child) on the website, social media, print and program ads. I understand that this registration commits me (my child) to participation in the registered activity and that I am responsible for payment of all applicable costs and fees by June 27th.
Payment Terms & Conditions *
I understand that my personal check or money order payment is to be received within five (5) business days of my registration. I understand that my payment (check or money order) and a copy/print of my registration confirmation must be mailed to: ST. JOSEPH SCHOOL, ATTN: CRISTY JORDAN, 2211 BROOKLYN AVENUE, FORT WAYNE, IN 46802