TAP
JAZZ
BALLET
Angie Caulfield and faculty members of ACD Dance will be offering a Fall session of Dance classes at Beall. Classes are a combination of jazz, tap and ballet. ACD faculty meet students at school dismissal. Students eat a small snack provided by student, change into dance attire and are escorted to class. Class starts at 3:45. Dismissal is at 4:45 at the Portables in the back parking lot. We will be having an end of the session in class performance on the last day of class. Classes are Tuesday afternoons. We have both a Level 1 and a Level 2 class dancing each day. Students are divided by age and ability. Students will need tap and ballet shoes and comfortable clothing. We have slightly used shoes for students to borrow if you prefer. Class schedule is as follows: September 26 October 3 October 10 October 17 October 24 No Class October 31 November 7 November 14 November 21 November 28 December 5 (In Class Performance) Cost for the session is $145.00. If interested, please return registration form and a check made out to ACD Dance to 1031 Wintergreen Terrace Rockville, MD 20850 or to register online please visit www.acddance.com. Please contact Angie Caulfield at
[email protected] for more details or information on need based scholarships.
Registration for Dance Class Beall Elementary Student’s Name __________________________________________________ Grade ________
Age________________
Teacher ______________
Parent’s Name ___________________________________________________ Address _________________________________________________________ City, State, Zip ___________________________________________________ Phone (H) __________________ (C)________________________ Email____________________________________________________________ Emergency Contact Name____________________ Emergency Phone__________ Medical Concerns ___________________________________________________ I give permission for my child, _______________________, to participate in dance classes taught by ACD Dance Company, LLC at Beall after school. I understand that dance can be dangerous. I accept that any activity involving motion can cause serious injury. The above named student has had a medical examination within the last twelve months and is physically, mentally and emotionally capable in participating in the sport of dance. I agree to be responsible for any medical bills incurred resulting from illness or injury while my child is participating in dance classes at Beall Elementary School. In the event of injury or illness, every effort will be made to contact parents or guardian. If necessary, I authorize agents of ACD Dance Company LLC to administer first aid and or/authorize medical treatment. I permit Angie Caulfield and ACD Dance Company, LLC to use pictures and the likeness of my child for use to promote ACD Dance Company, LLC on the dance website and promotional materials. I understand that I may revoke my consent for continued use of my child’s pictures and likeness at any time.
Parent/Guardian
Date
