Misty's Dance Unlimited Darby's Dancers Application Form 2019-20
Thank you for your interest in the Darby’s Dancers program at Misty’s Dance Unlimited. Darby’s Dancers is a 501(c)(3) organization founded by the parents of Darby Jones of Huntsville, Alabama. Darby’s Dancers provides an opportunity for children with special needs to participate in the performing arts through dance education. Charitable donations to “A Chance to Dance” 501(c)(3) provide the funding for Darby’s Dancers at Misty’s Dance Unlimited (MDU).
   
At once-a-week classes, Darby's Dancers learn various styles of dance in a fun, encouraging atmosphere. Dancers in the program gain confidence, coordination, strength and lifelong friends, all while feeling like a star.  DD also provides volunteer opportunities for teens. Our student volunteers learn important lessons in responsibility and friendship by providing one-on-one assistance to each dancer.
   
DD classes are taught by Miss Denise Meyer and take place in donated studio space at Misty’s Dance Unlimited. The charitable contributions of youth volunteers, dance instructors, community dance studios and local businesses allow DD to provide dance classes, classroom attire and recital costumes to special needs dancers at no cost to their parents.
 
2019-20 Darby’s Dancers Classes will be held on Fridays:
 5:30-6:00 PM - Younger Group (Ages 3-7)
 6:15-6:45 PM - Older Group (Ages 8+)

Classes begin on Friday, Sept. 27, 2019. Dancers will meet their buddy and get fitted for classroom attire and shoes.

The season ends with a Spring Recital performance in May 2020.

If you are interested in enrolling your child in the Darby’s Dancers program, please complete the application below with as much detail as possible.  We will use this information to partner our buddies with your dancer and for our team to review as we prepare for your dancer.  Let us know how we can make this a success for your child.  We will do our best to include these elements in our coaching plans for your dancer.
 
Our staff will be in contact very soon to inform you of current class availability as space is limited.

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Email *
Family Information
Parent(s) Name *
Full Home Address (Street, City, State, Zip Code) *
Home and Cell Phone Numbers *
Dancer Information
Dancer's Full Name *
Nickname (If preferred)
Birthdate *
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Dancer shirt size *
Dancer pant size *
Dancer shoe size *
School Attending *
Grade entering this Fall 2019 *
Allergies *
Preferred medical facility in the event of an emergency. *
What is your child's diagnosis.  Please be specific so we can best prepare for your child's needs. *
What items are addressed in their IEP or therapy plans that we can assist with or should be aware of? *
What would you like our teacher and buddies to do to help your dancer: *
Required
Please check any of the following items that apply to your dancer:
Middle and High School Age Assistants/Buddies
Our middle and high school age assistants/buddies are usually (but not mandatory) accomplished dancers who want to share what they love with your dancer. They will typically help with the following areas: help dancers stand, help with focus & following directions, help with safety issues related to stability, encourage verbally and with praise or hugs. If care is needed beyond this level, we will meet to see how we can work together to address needs.

Students must be able to exhibit basic communication skills (dancers can be non-verbal, just need to be able to communicate at a basic level). Students need to exhibit appropriate social behavior and general self-control that would be expected for their age with expected developmental disabilities. We are not trained special education experts and are not equipped to work with all students including severe discipline problems or children with difficult medical care. We will seek to provide dance education to as many children as possible. Your child’s safety is of the utmost importance to us. If for any reason, you have concerns regarding the safety/treatment of your child, please notify the dance instructor, program coordinator and studio owner immediately.

By checking yes below, I am acknowledging that I have read and understand the information above pertaining to middle and high school age assistants/buddies. *
Required
MDU Darby's Dancers Participation Acknowledgment and Release
• I have read and agree to abide by Misty Averill’s Dance Unlimited, LLC’s policies regarding tuition, late fees, costumes, attendance, and dance attire.
• I understand that Misty Averill’s Dance Unlimited, LLC reserves the right to refuse instruction to anyone not abiding by Misty Averill’s Dance Unlimited, LLC’s policies.
• I understand that Misty Averill’s Dance Unlimited, LLC reserves the right to cancel a class if enrollment falls below five students per class.
• I understand that Misty Averill’s Dance Unlimited, LLC is not responsible for lost items, stolen items, or unclaimed merchandise.
• I understand that participation in a dance program involves risk and possible injury. I understand that Misty Averill’s Dance Unlimited, LLC and its sta will not be held responsible for injuries sustained in class, while performing, or traveling to or from its facilities.
• I authorize Misty Averill’s Dance Unlimited, LLC to secure any emergency medical treatment my child might need.
• I grant Misty Averill’s Dance Unlimited, LLC (herein Misty's); The International Performing Arts Campus; Everything Dance, LLC; More Than Just Great Dancing®, LLC; More Than DancersTM, LLC, Midwest Dance Connection, LLC, Artistic Video Productions, Design Photography, and Atypik Studio irrevocable permission to use my child’s image and visual likeness in all forms and media for advertising, trade, and any other lawful purpose. I agree that all right, title and interest in and to all such images and any reproductions or derivative works shall be the exclusive property of Misty's. I agree that Misty's does not owe me any compensation for the acts that I have consented to in this Section.
• I hereby release Misty's from all liability or legal responsibility that may arise from the acts that I have authorized or consented to herein. I have carefully read and understand the terms and conditions of this Section.

By checking yes below, I am acknowledging that I am signing for my under age child or on behalf of a family member. I am granting permission for my child to participate in all aspects of Darby’s Dancers at MDU. *
Required
A copy of your responses will be emailed to the address you provided.
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