T.W.E.R.K. Summer Dance Intensive Registration Form
A summer dance intensive experience  that bridges shared intergenerational learning practices and diverse African diasporic dance forms as an activated communal space that revolutionizes kinship.The process is open to ages 15 and up.

Directions: 1). Complete this form; 2) You will receive an email from Olujimi with a unique pay code (specific to you and not to shared) for payment and directions on how to pay online.  

Please email olujimidance@gmail for further questions. 

THANK YOU
First and Last Name *
E-mail address *
Full mailing address (street address, city, state, zip code, country) *
Telephone number *
Date of Birth *
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Emergency Contact Name *
Emergency Contact Persons Telephone Number *
What would you like to register for?  *
Are you able to participate in the performance if selected? Attendance to all rehearsal is mandatory. *
What do you hope to gain from this experience and how will you apply the information learned? *
HEALTH WAIVER: 
Olujimi Dance Theatre  (ODT) and the South Miami Dade Cultural Arts Center (SMDCAC)   take every precaution to keep all participants safe, but accidents can ensue.  ODT and SMDCAC i assume no liability for any accidents, injuries, or losses that occur as a result of participation in the T.W.E.R.K. Summer Dance Intensive 2022.  Further, ODT and SMDCAC do not carry or manage participant medical insurance. As a participant of the T.W.E.R.K. Summer Dance Intensive, I understand that I [dancer, student, instructor, lecturer, panel member, participant, or volunteer] must be covered by an individual or family insurance policy. I also understand that in the event of personal injuries or losses, my own health insurance policy will be my only source of medical coverage and or reimbursement. In consideration of the dance lessons afforded to me under this agreement by  ODT and SMDCAC, and in recognition of the physical demands of dancing, I hereby knowingly, freely, and voluntarily waive any rights of cause of action of any kind whatsoever, arising as a result of such activity from which any liability may or could accrue to ODT AND SMDCAC, or its agents.

MEDIA WAIVER
Throughout the summer dance intensive, professional photographers and staff may take pictures of participants including but not limited to dancers, instructors, lecturers and panelists. These pictures may be used to be displayed on or in the following: • Studio walls • Promotional posters • Newspaper ads • Olujimi Brochure • ODT and/or SMDCAC website • Newspaper articles/reviews and social media sites. Please indicate permission to have your photo taken and for it to appear in printed material by signing this affidavit: I hereby grant permission to Olujimi Dance Theatre and South Miami Dade Cultural Arts Center to use photos, images and/or videos of me for advertising and publicity purposes including but, not limited to brochures, websites, newspaper articles, reviews, social media print advertisement, and other promotional materials. Permission is also hereby granted for ODT and SMDCAC to copyright such materials in its name. I understand that my personal information, such as name, address, age, etc., will not be released. I also understand that I will not receive any monetary compensation for the use of my photo, images, or videos that include me.
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