Dance Experience Camps Warriors Lamorinda Night Performance Fundraising for OYA and LMYA Proceeds from this event are donated to youth sports K -5th grade campers REGISTRATION FORM/ ------------------------------------------------------------------- Mail registration form and check payable to: All That Entertainment P.O. Box 5, Lafayette, CA 94549-0005 Or sign up online with Paypal option on website CONFIRMATION EMAIL WILL BE SENT WITH MORE DETAILS! Camp Details Practices: March 10 - 12, 2014 4:00 – 6:00 pm in Lafayette Performance: Friday, March 14, 2014 6:00pm arrival Perform at Oracle Arena Warriors v.s. Cleveland Camp Fees include: The two-afternoon camps train your child in dance technique, turns, jumps. Primetime routine, custom tank, skort, poms, bow, water and snacks during practices. $130 (plus REQUIRED, 2 Ticket minimum purchase) 2 ticket price $80 minimum / deadline tix price Feb. 10th Discounts: using uniform pieces you have already purchased from previous All That Entertainment camps and Girl scout troupes with 6 participants or more. Camp Warriors camp $130 with tank, skort, metallic poms and bow (Used for all camps until Oct. ) (Annual special Warriors camp poms) Girl scout troupe Fee $130 Discount $0 I have “All That” black skort <$17 discount> $108 I have “metallic poms” silver & pink <$22 discount> I have “metallic poms” silver $91 and pink & “All That” black skort <$39 discount> Subtract <$20 discount> with 6 from total members of troupe in camp Total $113 Grand Total camp 1 -$20 Dance Experience Camps Participant Information Name of student Address Phone School Grade Friends attending camp Girl Scout Troupe leader and #: Late Registration fees for rush shipping costs after February 28, 2014 Circle preferred Shirt size: YS4-6 YM8-10 YL12-14 AS4-6 AM 8 Fitted tank top true to size Skort size: YXS Skort YXS (Youth Extra Small) YS (Youth Small) YM (Youth Medium) YL (Youth Large) XS (Adult Extra Small) S (Adult Small) YS YM Waist 19” 21" 22" 23" 24" 26" YL AXS AS Length 9.5” 10" 10.5" 11" 12.5" 13" Parents Names Email Phone # where parents can be reached during camp: Mother Father Medical information: Family Doctor Phone Insurance Asthma yes no Policy # Diabetes yes no Allergies yes no Allergic to Medication currently taking Additional Medical Information that may be helpful In the event of an emergency occurring while my son/daughter is at Cassandra Montgomery’s sponsored class or performance, I grant permission to Cassandra Montgomery/ All That Entertainment, City of Lafayette, Golden State Warriors & their employees or representatives to take whatever action is necessary. Parent/Guardian initial. In the event that I cannot be reached, I hereby authorize Cassandra 2 Dance Experience Camps Montgomery/ All That Entertainment and her staff to give consent for my son/daughter to receive medical treatment. Parent/Guardian initial. I authorize Cassandra Montgomery and All That Entertainment to use any and all photographs and videos (images) and agree that Cassandra can Publish, copyright, and distribute images for any publicity materials, including but not limited to, website, posters, newspaper ads, and any other publicity or media advertising. Parent/Guardian initial. Parent/Guardian Permission: I understand that my child named above will be attending the All That Entertainment dance camp at All That Entertainment on March10 - 15, 2014. I understand that there are risks involved in any dance or exercise activity and I will not hold City of Lafayette, Golden State Warriors, All That Entertainment or Cassandra Montgomery, staff or representatives responsible in case of accident or injury at any time during the camp or performance activity. All participants must sign a separate medical liability and media release before joining in activities. Date Parent / Guardian Signature tickets for Game now to get seats for family and friends together. “Lamorinda Night” Ticket order information: at least 2 tickets purchase for each participant. Deadline for ticket orders with All That Entertainment: February 10, 2014 This will get you seats together and the discount price. Your tickets will be given to you at dance camp. Your performer must have an adult sitting with them where ever you choose to purchase their ticket. Adult supervision is not provided by All That Entertainment or Warriors except during performance time. #tickets ticket price $90 $40 seat level total $ Lower corner Club 200 sideline Up high where we always sit but 100 seats together. 3 GOING FAST!! Only 24 seats This is where I will plan on each camper sitting for their required 2 tix purchase unless I hear otherwise. We need to get the tickets for the game by Feb10th.
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