D’Valda &

Sirico Summ

er 2018 RegistrationStudent ______________________________________ D

OB _______ A

llergies/Special Needs ______________________________

Parent(s) Nam

e ______________________________________________ Email __________________________________________

Address ___________________________________________________ City ____________________ State _____ Zip ___________

Phone ____________________________________ Emergency Contact _______________________ Phone ___________________

Select programs, sessions and dates. Enter total due for all program

s and complete paym

ent information. Please do not forget to sign

the registration form!

❍ A

DV

ENTU

RE & FA

NTA

SY WEEKS (ages 3-6) / $249 1st w

k / $199 each additional week

____June 25th - 29th ____July 9th - 13th ____July 16th - 20th ____July 23rd - 27th

❍ D

AN

CE INTEN

SIVE (ages 8 &

up) / All dates m

andatory: June 20 - 27 and Aug 27 - Sept 7 / $795

❍ V

OCA

L INTEN

SIVE (ages 8 &

up) / All dates m

andatory: June 20 - 27 and Aug 27 - Sept 7 / $795

❍ SU

MM

ER DA

NCE CLA

SSES (ages 1-12) / 8 weeks: June 30 through August 25 (no classes w

eek of July 29)

Ages 1 - 3: ____ Zumbini Ages 3 - 4: ____ Ballet Ages 5 - 7: ____ Ballet Ages 8 - 12: ____ Ballet ____ Tap

____ Jazz & Tap ____ Jazz &

Tap ____ Jazz & H

ip Hop

❍ SU

MM

ER MU

SIC LESSON

S (ages 5 & up) / 8 w

eeks: June 30 through August 25 (no classes week of July 29) / $368

____Tuesdays ____Thursdays ____Saturdays / Please contact the front desk to determine available tim

e _________

TOTA

L DU

E FOR A

LL PROG

RAM

S $ _______________________ ❍

Check ❍ M

C ❍ VS ❍

Am

ex

NAM

E ON

CARD

_________________________________________________________ BILLING

ZIP COD

E _____________

CARD

# ___________________________________________________________________ EXP __________ CCV ________

I grant permission to the staff of the D

’Valda & Sirico D

ance and Music Centre to take first aid or em

ergency measures as judged necessary for the

care and protection of my child w

hile under the supervision of the studio. In case of medical em

ergency, I understand that my child w

ill be trans-ported to an appropriate m

edical facility by the local emergency unit for treatm

ent it the emergency unit deem

s it necessary. I understand that in som

e medical situations the staff w

ill need to contact the emergency resource before the child’s parent, physician, and or other person acting on

the parent’s behalf. I also understand and agree that the child’s parents or legal guardians shall be responsible for any expenses incurred. As the

parent/legal guardian of ________________, I agree to hold harmless from

any and all liability the D’Valda &

Sirico Dance and M

usic Centre Centre, its offi

cers and employees both in their professional capacity and personally for all injury or illness resulting from

or in any way connected w

ith his/her participation in the classes, activities or special events at the D

’Valda & Sirico D

ance and Music Centre. I understand that it is the D

’Valda &

Sirico Dance and M

usic Centre’s policy that while under the supervision of the D

ance and Music Centre no child is allow

ed to leave the building w

ithout a parent/legal guardian or the written perm

ission of a parent/legal guardian and that the parent/legal guardian assumes full responsibil-

ity for the actions and behavior of the child. Parents/legal guardians give their permission to the D

’Valda & Sirico D

ance and Music Centre to use

photos and/or video of their child in connection with D

ance and Music Centre publications, advertising, TV, and new

s coverage. I agree that the total due w

ill be charged in full to the card above. All deposits and paym

ents are nonrefundable.

Signature _______________________________________________________________________________ Date ________________

FANTASY & ADVETURE WEEKSMon - Fri • 9:30am to 11:30am • Ages 3-6

$249 First Week • $199 Each Additional Week

Dance terminology, improvisation and character work are all in-troduced through magical fairy tales and classic children’s stories. Daily arts & crafts, snack and entertaining activities such as our character tea party add to the day.

On Friday, family and friends are invited to attend a special presentation to see their children dance the story created throughout the week.

Each Fantasy & Adventure week will include a different magical theme featuring characters such as Cinderella, Pirates and Prin-cesses, Little Pony or Frozen.

Four themed weeks to choose from:

June 25th - 29th: The Royal Party

July 9th - 13th: Under & Over The Sea

July 16th - 20th: Fairies & Magical Friends

July 23rd- 27th: Sheroes & Heroes

DANCE / VOCAL INTENSIVE Wed-Fri 6/20 to 6/22 - June Intensive Part I

Mon-Wed 6/25 to 6/27 - June Intensive Part II

Mon-Thur 8/27 to 8/30 - Fall Intensive Part I

Tues-Friday 9/4 to 9/7 - Fall Intensive Part II

Ages 8 - 12 / Times vary by age/level

All four sessions are mandatory / $795

D’Valda & Sirico’s Intensive is a must for the intermediate/advanced dancer or singer, age 8 and up, motivatedto take their training to next level.

The Intensive includes a diverse technique class schedule as well as workshops in voice, choreography, and auditioning. The Dance/Vocal Intensive is a prerequisite for students auditioning for The D’Valda & Sirico Performance Team and Companies.

The Intensive is a challenging and fun program for the focussed student committed to taking full advantage of this learning opportunity. Participants are expected to take all classes as scheduled and to be open to experiencing a variety of dance/vocal styles. Dancers and singers interested in a more recreational experience should consider our Saturday Summer Class Series.

SUMMER DANCE CLASSES

Saturdays • Ages 18 months to 12 years 8 Week Session • June 30th - Aug. 25th

One Class per Week $140 / 2 per Week $252 / 3 per Week $384

Ages 1 to 3 years with Parent / 9amThe Zumbini® program combines music, dance and educational tools for 45 minutes of can’t-stop, won’t-stop bonding, learning, and fun! Through this 8 week session, Zumbini® not only nurtures their love of movement so it becomes a way of life, but gives you the chance to nurture your inner child as well!

Ages 3 through 4 years / Ballet 9am / Jazz & Tap 10amDuring a fun filled 45 minute class each small group of dancers experiences a series of creative activities that are designed to encourage imagination, gross and fine motor skills musicality and spacial awareness.

Ages 5 through 7 years / Ballet 10am / Jazz & Tap 11amOne hour exciting and fun classes to introduce new choreography, musicality and the love of dance.

Ages 8 through 12years / Jazz & Hip Hop 10amBallet 11am / Tap 12pmContinue your training or get started with Saturday classes. Eight weeks of one hour classes focussed on learning and having fun in a creative atmosphere!

SUMMER MUSIC LESSONS

Tues, Thur and Sat • Ages 5 and up 8 Week Session • June 30th - Aug. 25th

Half hour private lessons in Voice and Piano are available on Tuesdays, Thursdays and Saturdays during our eight week Summer Session.

Contact the Dance and Music Centre for available lesson times.

(203) 255 - 9440