INVITATION TO ALL SURREY STUDENTS & TEACHERS Surrey Secondary Dance Teacher’s Association presents... Yeah… We Dance! Monday, May 30, 2011 @ Frank Hurt Secondary PROFESSIONAL Dance instructors from Lower Mainland Cost - $30 for 3 classes $45 with a T-shirt.
Bring your money into your dance/sponsor teacher ASAP to guarantee your choices.
Registration Warm-up Session 1 Session 2 Session 3
9-9:30am 9:35-9:50 10:00-11:00 11:15- 12:15 12:30-1:30pm
Large Gym Latin Ballroom Breakdance - Footwork and TopRocking Breakdance -Power
Dickson Lee Dickson Lee Victor
Small Gym Poppin/ Locking Open Old Skool Hip Hop Open Contemporary Intro
Cristina Cristina Jane Osborne
Small Studio Jazz 1 Jazz 2 Tap intro/1
Dana Madder Dana Madder Jennifer Bishop
For schools without a dance or sponsor teacher, please contact Paula Johnson by email: Johnson_paula@sd36.bc.ca (on first class)
Registration Form – Yeah… We Dance!
Student’s Full Name: ___________________________________________
Student Number: ______________________________________________
Student choices – you must choose 3 classes
Session 1: ____________________________________________________
Session 2: ____________________________________________________
Session 3: ____________________________________________________
T-shirt: Yes, I would like a t-shirt!!! My size is (please circle): S M L
No t-shirt this time… thanks!
Media Consent – We will be making a video of the event to post on YouTube and taking pictures for teacher web pages. Please confirm your media consent by signing the form below.
School / District Websites
In accordance with the Freedom of Information and Protection of Privacy Act, the Surrey School District requires consent to use a students’ full name or photograph/video on school or district websites accessible to the general public. Therefore, your permission is requested to post your child’s full name, photograph or video of your child in connection with positive, day-to-day school activities or personal accomplishments.
_________ Yes, as the parent or guardian of the student named below, I give my consent to the publication of his/her name and/or photo or video on the school or district website as described above.
_________ No, as the parent or guardian of the student named below, I do not give my consent for the publication of his/her name, photo or video on school or district websites.
______________________________________________________________________
Parent / Guardian Signature Date
______________________________________________________________________
Secondary Student Signature Date
Student’s Name (print):_________________________________Div: _____Grade: ____
Field Trip Consent:
is hereby given permission to participate in a
(Full Name of Pupil)
field trip from Surrey, British Columbia, to Frank Hurt Secondary
(Destination)
from May 30, 2011 9am to May 30, 2011 1:30pm
(Date and Time of Departure) (Date and Time of Return)
inclusive, under the care and control of Paula Johnson
(Supervisor(s))
who are appointed guardians of the above-mentioned pupils for the duration of this trip. Any or all of the guardians are empowered to engage medical personnel and to authorize treatment.
Students will be traveling by: Transportation is not provided.
Signed at Surrey, British Columbia,
______________________, 200___ X_____________________________________
(month) (day) (Signature of Parent/Guardian)
MEDICAL INFORMATION SECTION
Student Name: _______________________
Student Number: ________________
Emergency Phone Number: ___________________ Family Doctor :__________________
Doctor’s Phone Number: ___________________ Care Card # ___________________
Known Disabilities and/or Allergies (also list medications student is now taking):