JazzAntiqua Dance & Music Ensemble - LEGACY Jazz Dance Project 2024 Registration Form
Latrice Postell, Program Coordinator
Madeline Sharp, Program Assistant

Questions? Email: JAENGAGE@GMAIL.COM

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Dear Students and Parents,

The award-winning JazzAntiqua Dance & Music Ensemble was founded in 1993 with a commitment to jazz dance education, preservation and creation, and a dedication to celebrating the roots and history of the jazz tradition.

Now in its 5th year, the LEGACY Jazz Dance Project is a FREE program open to dancers ages 13-18 with at least one year of dance training. The program includes Saturday class sessions in the Spring, Summer and Fall, along with one-week Summer Intensives. Experienced and committed dancers are invited to also participate in the LEGACY Dance Company for a deeper experience working with guest choreographers, performing with JazzAntiqua, and participating in a variety of events across Southern California and beyond. 

All classes take place at the Nate Holden Performing Arts Center.
4718 W. Washington Blvd.
Los Angeles, CA 90016

SATURDAY  SCHEDULE
10am-12pm  
*LEGACY Dance Company members continue until 1pm
Spring Session: April 13 - June 1
Summer Session: June 15 - August 3
Fall Session: September 7 - November 2

1-WEEK SUMMER INTENSIVES
Monday-Friday, 10am-3pm
June 24-28 
July 15-19

For questions and additional information about the LEGACY Jazz Dance Project please email JAENGAGE@GMAIL.COM.

For more information about JazzAntiqua and the LEGACY Jazz Dance Project, visit: WWW.JAZZANTIQUA.ORG

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Email *
PARTICIPANT INFORMATION
Student Last Name *
Student First Name *
Student Age *
School Attending *
Student Email Address *
Student Cell Phone # *
Briefly explain why you would like to participate in the LEGACY Jazz Dance Project *
Briefly describe your dance experience *
Are you participating in the LEGACY Dance Company? *
PARENT / GUARDIAN INFORMATION
Only to be completed if participant is under the age of 18.
Parent / Guardian First and Last Name *
Parent/ Guardian Address, City, State, Zip Code *
Parent / Guardian Email Address *
Parent / Guardian Telephone # *
EMERGENCY CONTACT / MEDICAL INFORMATION
To be completed for all registrants.
Emergency Contact First and Last Name, Cell Phone Number, and Relationship to Participant  *
List injuries, medical conditions/concerns, medications you would like Program staff and teachers to be aware of. *
PHOTO AND VIDEO ACKNOWLEDGEMENT
To be completed by all registrants
Participant (if 18 years old) or Parent/Guardian acknowledges and agrees that Participant may appear in photos and videos that will be used for documentation, social media, promotion, grant reports and applications and other informational purposes on behalf of JazzAntiqua. Participant (if 18 years old) or Parent / Guardian (if participant is under the age of 18) - enter your full name then select today's date below. *
Select today's date *
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LIABILITY DISCLAIMER, RELEASE AND WAIVER
Your agreement to participate in the LEGACY Jazz Dance Project means that you fully agree to the following:

Dancing is a strenuous activity from which injuries could arise. I understand that I have enrolled or enrolled my child/ward in a program of potentially strenuous physical activity. JazzAntiqua Dance & Music Ensemble (Jazzantiqua, Inc.), the teachers and program administrators are not liable for personal injuries.

Each student may decline to participate in any activity. Please inform LEGACY program coordinator, assistant, and instructors of any limitations your child or ward might have. If you are 18 years old, please inform LEGACY program coordinator, assistant, and instructors of any limitations you have.

I represent that I am physically able to participate in all activities, or that my child/ward is physically able to participate in all activities.

I, for myself, my child/ward, my spouse, heirs, legal representatives and assigns, expressly release, waive, discharge and hold harmless JazzAntiqua Dance & Music Ensemble (Jazzantiqua, Inc.), its officers, directors, employees, teachers, agents, successors, predecessors, sponsors, legal representatives and assigns from all claims, demands, losses, actions, judgments, suits, executions and liabilities of any kind.

Agreement to this Liability Waiver will act as your continued agreement to all 2024 class sessions, workshops, rehearsals, performances presented in-person or via Zoom or any other video conferencing tool.

Participant (if 18 years old) or Parent/Guardian acknowledges, agrees and accepts the Liability Disclaimer, Release and Waiver. Participant (if 18 years old) or Parent / Guardian (if participant is under the age of 18) - enter your full name then select today's date below. *
Select today's date *
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DD
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A copy of your responses will be emailed to the address you provided.
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