Dance Fusion Summer Intensive 2023

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May 31st-June 10th 2023 and or June 5th-10th
Registration/ Medical Release Form

FULL*** Adding 4 days; Wednesday- Saturday with 3 main instructors Adam Parson, Tanner Blee, and Ryan “BOSCO” Baker. Every year, the intermediate and advanced students wish they had more time with our guest artists, so we are listening and implementing the option. These extra days will be technique driven and focused with the following week more choreography focused. This is an addition to the following week. Times are approximately a 9:30-5p schedule, Saturday 10-3p.

Pre-register by March 15th with $100 non-refundable, deposit down then remaining deposit balance due April 1st $400.00 only of $875! Remaining ($375) due May 15th.

You must put a $100, non-refundable, deposit down to get the pre-registration discount or $925, after April 1st. This option is only available to Intermediate and Advanced students (levels 4-6).

PARTIAL***June 5th-10th 9:30-5:00p and Saturday 10:00-2:00p: Pre-register by March 15th with $100 non-refundable, deposit down then remaining deposit balance due April 1st 225 only of $575! Remaining ($250) due May 15th.

You must put a $100, non-refundable, deposit down to get the pre-registration discount or $625 after April 1st.

*The student showcase is a performance that will take place at Robinson Theatre at Colorado Mesa University this year! Each family will receive 2 complimentary tickets to this event with additional tickets of just $15 each to help pay for the theatre rental. The show will demonstrate all of the work that the students have learned during the summer intensive as well as some surprises. This event is open to the public to create a great audience for our participants.
(EACH STUDENT NEEDS A SEPARATE ONE)

Email *

Student: First, Last Name *

Date of Birth *

YYYY

Age, M/F *

FULL or PARTIAL *

FULL, May 31st- June 10th (only available for levels 4-6 or with permission)

PARTIAL, June 5th-10th

Parents’ Name: First, Last name *

Contact Phone and Alt. Phone (please include who's phone # it is) *

Mailing Address *

Email Address *

Dance Studio Affiliation *

Dance Studio Phone # *

Dance Studio Email *

Dance Studio address *

Current classes taken *

Number of years dance training *

List any health, medical, or physical problems and/ or conditions below and explain limitations. *

Family Doctor’s Name *

Family Doctor’s Phone # *

Alternate Emergency Contact Name/ phone: *

Please select one of the following options: *

$100 deposit due on March 15th to secure my child’s spot and pre- registration discount

I have enclosed a check for the $262.50 (partial)/ $412.50 (full) (does not include the deposit) before April 1st to secure my child’s spot w/ the final $262.50/ $412.50 due to May 15th

I have enclosed payment for the full pre-registration amount of $575 (partial)/ $875 (full) by April 1st to save $50!

I have enclosed Full payment of $625 (partial intensive)/ $925 (full/ extended intensive) after April 1st for the full amount.

I authorize Absolute Dance to charge my card and use my child’s photo, video recording, and/or written statements for advertising, display, or other use, without review by, or compensation to, participant or parent/s. Absolute Dance is not responsible for participants’ lost, stolen, or damaged personal belongings. ABSOLUTE DANCE IS NOT RESPONSIBLE FOR INJURIES ON THE PREMISES. By signing below, I acknowledge that dance, like any other physical activity, can result in injury, and therefore, I will not hold ABSOLUTE DANCE and their associated staff liable for injuries incurred during class or on the premises. I understand and agree that I am liable for the full tuition amount indicated on any Absolute Dance materials, including any late charges, fees, or interest, even in the event of the student's withdrawal or dismissal from the program before it is complete. I understand that Absolute Dance does not offer any tuition refunds for missed classes, withdrawal, or dismissal from the program. Account credit will be ONLY be given with Director's approval, if a student must withdraw due to severe illness or injury, to be eligible they must supply a doctor's note with the request to withdraw from the program. Parent/Guardian Signature Date *

A copy of your responses will be emailed to the address you provided.

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