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Performing Arts Summer Camp.Registration Form
 

Performing Arts Summer Camp.Registration Form

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To register for Elementals download this file complete it and take a copy with you on the day of registration! You may also email me a copy: kofiomar@caribserve.net

To register for Elementals download this file complete it and take a copy with you on the day of registration! You may also email me a copy: kofiomar@caribserve.net

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    Performing Arts Summer Camp.Registration Form Performing Arts Summer Camp.Registration Form Document Transcript

    • Personal Data Form for Performing Arts Summer Camp 2009 Print and take a copy of this form with you to the Camp. Also leave a copy at home with a friend or relative. Personal Information (Please complete form with Blocked Capital Letters) Full name Nickname Grade Level Home address Home phone Mobile or cellular phone Home fax Home e-mail address Birthday (MM/DD/YYYY) Current Age Parents / Guardians Information Mother’s full name Father’s full name Guardian’s full name (If not child’s Parent) Business Information Company / Place of work Business address Department / Job title Business phone Business fax Your preferred e-mail address Web page address Emergency and Medical Information Since we will be providing basic medical care (only ice-packs and band aids), Parents need to provide emergency contact information. Anything more serious than basic care, parents will be notified via the emergency contact information provided or at your place of work. If we are unable to reach you, an ambulance will be called. PLEASE LIST EMERGENCY CONTACT INFORMATION CAREFULLY. In case of emergency, contact Emergency contact’s address Emergency contact’s phone Doctor’s name Doctor’s phone Doctor’s address Medical insurance carrier or Card Vitale No. Blood type Website: http://www.kofiwalker.com Email: kofiomar@caribserve.net Tel: +59 0690 22 92 59 Fax: 590 27 63 83 Page 1 of 4
    • Personal Data Form for Performing Arts Summer Camp 2009 Personal Information (Please complete form with Blocked Capital Letters) Known medical conditions Known allergies Current medications Please list any other known medical condition the student may have. Field Trips #1 #2 #3 #4 1st Dates July 10th July 17th July 24th July 31st 2nd Date August 7th August 14th August 21st August 28th This program may not be able to meet all educational special needs, so please list any below so we can make that determination. These will be kept COMPLETELY CONFIDENTIAL. Special Needs These needs will only be discussed with my assistant(s) / helpers. Discipline To ensure that all students have the best experience possible this summer, the following Discipline Action Plan for Fire, Earth, Wind and Water will be in effect for this Performing Arts Summer Camp. If a student is disruptive in class, the student can expect the Disruptive in Class following consequences. 1st Verbal Warning nd 2 Supervised Time Out rd 3 Parent phone call Continuous disruption Student will be removed from the FEWW Camp with no refund. I am kindly asking that you discuss these consequences with your child at home. During the first week of classes I will also be reviewing these consequences with the students. After reading through this form, please fill out all the sections. If you have any questions, please do not hesitate to contact me directly on 0690 22 92 59 or send me an email at kofiomar@caribserve.net Please note that photos and videos will be taken of all students in this activity and will remain my property for future use in Community Performing Arts Activities. Website: http://www.kofiwalker.com Email: kofiomar@caribserve.net Tel: +59 0690 22 92 59 Fax: 590 27 63 83 Page 2 of 4
    • Personal Data Form for Performing Arts Summer Camp 2009 Personal Information (Please complete form with Blocked Capital Letters) Parents’ / Guardians’ Signature I hereby give my son/daughter permission to participate in the FEWW Performing Arts Summer Camp Program. I have read and understand all the rules and regulations mentioned above. Parents’ / Guardian’s Signature: Date: Activities: Students will participate in all activities listed below. Dance Dance Technique and Movement including Afro-Caribbean Dance Direction and instructions will be given mainly in English but Speech and Drama performance will be in French and in English! Poetry Poetry writing and recital of students own works using the theme FEWW. Focus will be placed on building confidence in the child, building an Modeling / Posture awareness of posture and how best to publicly present themselves. The Broadway Musical Theatre will focus on our Creole Traditions of Percussion n Chant Percussion and Chant using the 5 Gallon Water Bottles. Students will be introduced to costume designing for film or stage Costume Designs production. This will be demonstrated in their Fashion Presentation. Face Painting Introduction to Face Painting using the theme FEWW Art and Craft Painting, Drawing, Craft, Cartoon or the creation of 3D images. Field Trips Lé Gallion, Butterfly Farm, Kali’s Beach, maybe the Fire Department TBC! Tuition: Please indicate your choice by ticking √ A, B or C June 29th – July 31st, 2009 (Please Calculate your fees in the far right column) . Fees Your Fee Camp I Registration Fee € 15.00 A Full package 4 weeks € 200.00 B - Weekly € 90.00 C - Daily € 25.00 TOTAL 15 % discount is applicable to 2 or more siblings! € 215.00 e.g. √ [A] 4 Weeks = € 215.00 rd th August 3 – August 28 , 2009 (Please Calculate your fees in the far right column) . Fees Your Fee Camp II Registration Fee € 15.00 A Full package 4 weeks € 200.00 B - Weekly € 90.00 C - Daily € 25.00 TOTAL 15 % discount is applicable to 2 or more siblings! Website: http://www.kofiwalker.com Email: kofiomar@caribserve.net Tel: +59 0690 22 92 59 Fax: 590 27 63 83 Page 3 of 4
    • Personal Data Form for Performing Arts Summer Camp 2009 Please email this form to kofiomar@caribserve.net or fax it to 590 27 63 83 for the attention of Mr. Kofi Walker. You may also return the form to the School for the attention of Madam Brookson in an envelope with payment addressed to my attention. Marked FEWW Performing Arts Summer Camp. Herve Williams 1 Concordia, St. Martin Thanks in advance for your time and interest. Website: http://www.kofiwalker.com Email: kofiomar@caribserve.net Tel: +59 0690 22 92 59 Fax: 590 27 63 83 Page 4 of 4