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Saturday 10:30am - 4:30pm 10:30-12 Conditioning, Technique, Body Alignment 12-1:30 Boundless Techniques and improv 1:30-2 Break 2-3:30 Phrase work and rep 3:30-4:30 Task based exploration Sunday 9am-2pm 9-10:30 Ballet 10:30-11:30 partner work 11:30-11:45 mindfulness journal 11:45-12:15 break 12:15-1:15 floor work and rhythm 1:15-2 Boundless technique and exploration

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	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)*

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	Student's First Name: *	Last Name: *
	Student Gender: *	Birth Date: * (format=mm/dd/yyyy)
	Student Email:
	School:*	Grade Level:*
	Disabilities (Leave blank if NONE):
	Allergies:
	Medications:
	Primary Doctor:
	Is student in recital (Y/N):*

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