Dominique Fewell

What to Wear: Creative movement/preballet and tumbling: Pink leotard, pink footless tights, pink ballet skirt and pink ballet shoes. Hair must be secured in a bun or ponytail. Boys—white T-shirt, black shorts, black ballet shoes. Our Mission is to bring honor, glory, and praise to God through the art of dance. Our goals are: •

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To engage students in active learning, to assist them in establishing a meaningful value system, and to set high expectations for each child. To provide quality dance education in an environment that nurtures every child’s self-confidence, discipline, memory and grace. To honor Jesus Christ in all our activities and build unity in the body of Christ.

Dance Ministries at First Baptist of Decatur

ITEMS MAY BE PURCHASED AT LOCAL DANCE STORES (see below) OR AT www.discountdance.com: Center Stage II : 3675 Satellite Blvd. Suite 510 Duluth, GA 770.814.9500

Classes Start: September 4, 2008 Classes Conclude: May 2009

Footloose Dancewear, Inc.: 2308 B Henry Clower, Blvd. Snellville, GA 770.972.6634 Shapes Dance & Aerobic Wear: The Shops of Dunwoody 5482 Chamblee Rd. Dunwoody, GA 770.396.1078

COSTUME FEES: Costuming will be required for one or more performances. $25.00 deposit PER CLASS taken due in November. Remainder due in January. (will not exceed $50.00 PER CLASS) *Possible Recital fee for tentative theatre

Dominique Fewell, Director 678-908-0489

All classes begin with bible verse

...a time to dance is offering a combined preballet/creative movement and tumbling class for boys and girls. This is a fun introduction for little ones to the world of dance, movement and tumbling while focusing on the love of Christ. They will gain self-confidence, coordination, flexibility and grace while having fun through imagery and games. In addition, they will learn weekly Bible lessons, memorize Bible verses and have meaningful prayer time.

Registration Form Participant Information Class__________________________ Day_____________________ Time___________ Name_________________________________________ Age_____ DOB___/___/___ Address________________________________________________________________ City__________________________ State___________ Zip Code_________________

memorization, application to real life

Email____________________________________________________________________

issues, and prayer time.

Guardian Information Mother’s Name__________________________________________________________

Thursday 9:45-10:35 am: Creative Movement/PreBallet and Tumbling Ages 3– younger 4s (3 as of Sept. 1) Class Limit—10: Thursday 10:45-11:35 p.m. Creative Movement/PreBallet and Tumbling Ages older 4s—5 Class Limit—10

Father’s Name___________________________________________________________ Home_____________________________ Work________________________________ Cell (M)___________________________ Cell (F)______________________________ Emergency Contact______________________________________________________ Relationship_________________________ Telephone__________________________ Medical Information Primary Care Physician_______________________ ph #_______________________ Address_________________________________________________________________

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Fees (see back for recital and costume fees): Registration: $15.00 per child $25.00 per family (this is non-refundable) Tuition: $25.00 per month (1st month due at time of registration)

City__________________________ State___________ Zip Code__________________ Insurance Carrier_________________________________________________________ Policy Number____________________________________________________________ Allergies_________________________________________________________________ List all previous injuries, physical limitations, and current medications_________ _________________________________________________________________________ _________________________________________________________________________

Authorization

Notice of Termination: I understand that a written one (1) month termination of participation notice be submitted to

*You may pay a one time TUITION fee for the entire year for $215.00 plus the registration fee. All other discounts will apply to the one time fee. Please call Director for details.

the Director. I understand that in any activity the potential exists for injury, minimal to catastrophic. , it’s employees, agents, officer’s, and directors shall not be responsible for losses and damages associated in any activity, exhibition, or travel to or from any event in which the named above is involved. Furthermore, I hereby release staff to render first aid in the event

Discounts: Sibling Discount: $7.50 PER CLASS Two or more classes per student: $5.00 PER MONTH

of any injury or illness, to seek medical assistance if deemed necessary and to transport to a medical facility or to call an ambulance.

Parental Signature ____________________________ Date________________