Registration
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CityDance is a fun, five week program! We will have one after school ballet class per week, held over Zoom. These classes are free and no special dance clothing is needed! Zoom information will be emailed to you after you register! CityDance es una programa divertido durando cinco semanas. Las clases son una vez a la semana despues a la escuela, transmitada por Zoom. Las clases son gratuitas! No hay ropa especial necesitada. Cuando su registro es completo, cas a recibir la information de Zoom.
Event:
Start Date/Time:
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Room:
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Parents Information
First Name:
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Last Name:
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Type
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Caregiver
Father
Grandparent
Guardian
Mother
Parent
Home Phone:
Cell #:
Work #:
Email:
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(Emails are kept confidential)
Address:
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City:
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State:
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DE
FL
GA
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IA
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ME
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Zip:
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Students entered below will be added to your family's account
Add New Student #1:
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Student's First Name:
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Last Name:
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Student Gender:
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Female
Male
Birth Date:
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(format=mm/dd/yyyy)
Student Email:
Academic School:
2024-2025 Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Allergies (Leave blank if NONE):
Years of ballet training:
Most recent ballet studio:
Most recent hrs/week of ballet:
:
Add New Student #2:
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Student's First Name:
*
Last Name:
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Student Gender:
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Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Academic School:
2024-2025 Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Allergies (Leave blank if NONE):
Years of ballet training:
Most recent ballet studio:
Most recent hrs/week of ballet:
:
Add New Student #3:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Academic School:
2024-2025 Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Allergies (Leave blank if NONE):
Years of ballet training:
Most recent ballet studio:
Most recent hrs/week of ballet:
:
Add New Student #4:
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Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Academic School:
2024-2025 Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Allergies (Leave blank if NONE):
Years of ballet training:
Most recent ballet studio:
Most recent hrs/week of ballet:
:
Add New Student #5:
(Show-Hide Details)
Student's First Name:
*
Last Name:
*
Student Gender:
*
Female
Male
Birth Date:
*
(format=mm/dd/yyyy)
Student Email:
Academic School:
2024-2025 Grade Level:
preschool
kindergarten
1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
college
college-freshman
college-sophomore
college-junior
college-senior
Unknown value
Allergies (Leave blank if NONE):
Years of ballet training:
Most recent ballet studio:
Most recent hrs/week of ballet:
:
Questions/Options:
Has your student taken a dance class before? (Su estudiante ha tomado una clase de baile antes de hoy?)
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Yes
No
Which is the main reason you want your student to participate? (Por que escogistes a tu estudiante para participar?) 1. To learn ballet 2. To exercise or 3. They need an after school activity
Student Ethnicity (American Indian, Asian, Black, Hispanic or Latino, Pacific Islander, or White)/ Qual es la Etina/raza de el estudiante? (Asiatico, Blanco, Hispano o Latino, Negro, Indio Americano)
Additional Information:
Waiver 1
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In consideration for this opportunity to participate in a Texas Ballet Theater ballet class at Alice Carlson Applied Learning Center (the “Activity”), the undersigned, on behalf of “Student” and his/her parents, family members, relatives, heirs, and any party claiming by, through, or under the foregoing parties (collectively, the “Releasing Parties”), acknowledges and agrees as follows:
Student has voluntarily and with approval of the undersigned chosen to participate in the Activity with full knowledge and disclosure of the risks and hazards described below. The Activity may be strenuous and present an inherent risk of personal injury or property damage. The undersigned is responsible for insuring that Student is medically fit prior to participating in the Activity, and represents that Student is medically fit and has no know or suspected health conditions that would prohibit or limit his or her participation in the Activity in any manner. At all times during his/her participation, Student will properly utilize all recommended safety equipment and follow all recommended instructions and procedures pertaining to the Activity. While such equipment, instructions and procedures may reduce the inherent risk of the Activity, a substantial risk of personal injury or property damage may remain.
A cambio de la oportunidad de participar en la clase de Ballet de Texas Ballet Theater en Alice Carlson Applied Learning Center (la “Actividad”), el que suscribe, en representación de el “Estudiante” y sus papas, miembros de familia, parientes, herederos, y cualquier otra parte que pueda demandar en nombre o por conducto de las mencionadas personas (en su conjunto, las “Partes Renunciantes”):
1. El Estudiante de manera voluntaria y con la aprobación del que subscribe, elije participar en la Actividad con pleno conocimiento y sujeto a los riesgos y peligros que se describen abajo. La Actividad puede ser extenuante y presenta un riesgo inherente para que ocurran daños físicos o daños al patrimonio. El que subscribe es responsable de asegurar que el Estudiante esta en el estado físico necesario para participar en la Actividad y declara que el Estudiante están en buenas condiciones físicas y que no tiene o sospecha que tenga alguna condición medica que le prohíba o limite su participación de manera alguna en la Actividad. En todo momento durante su participación en la Actividad, el Estudiante utilizará todas los equipos de seguridad recomendados y seguirá todas las instrucciones recomendadas y los procedimientos pertinentes a la Actividad. Aunque dichos equipos, instrucciones y procedimientos pueden reducir el riesgo inherente de la Actividad, el riesgo de daño físicos o de patrimoniales seguirá siendo substancial.
I've read the above and agree.
FWISD Waiver
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2. THE RELEASING PARTIES KNOWINGLY AND VOLUNTARILY ASSUME ALL KNOWN AND UNKNOWN RISK OF INJURY, LOSS OR HARM THAT MAY BE INCURRED OR SUFFERED, INCLUDING BUT NOT LIMITED TO PERSONAL INJURY, DISCOMFORT, PAIN AND SUFFERING, DISABILITY, PARALYSIS, DEATH, MENTAL ANGUISH OR PROPERTY DAMAGE, IN ANY WAY CAUSED BY OR RELATED TO THE ACTIVITY, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASED PARTIES OR OTHERS. THE RELEASING PARTIES EXPRESSLY RELEASE AND HOLD HARMLESS THE FORT WORTH INDEPENDENT SCHOOL DISTRICT AND ITS PREDECESSORS, SUCCESSORS, PARENTS, SUBSIDIARIES, OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, REPRESENTATIVES, VOLUNTEERS, ATTORNEYS, INSURERS, AFFILIATES, ASSOCIATED ENTITIES AND ASSIGNS FROM ANY AND ALL CLAIMS, ACTIONS, CAUSES OF ACTION, DAMAGES, EXPENSES, COSTS OR LIABILITIES OF ANY KIND (“LOSSES”) RELATED TO OR ARISING FROM THE ACTIVITY, INCLUDING BUT NOT LIMITED TO ANY ASSOCIATED TRAVEL AND/OR ACCOMMODATION PREPARATORY TO, DURING, AND FOLLOWING SUCH ACTIVITY, WHETHER SUCH LOSSES ARISE FROM STUDENT’S OWN NEGLIGENCE, THE NEGLIGENCE OF ANY RELEASED PARTY OR ANY THIRD PARTY, OR ANY OTHER CAUSE.
2. LAS PARTES RENUNCIANTES CON CONOCIMIENTO Y DE MANERA VOLUNTARIA ASUMEN TODOS LOS RIESGOS, SEAN CONOCIDOS O DESCONOCIDOS, DE DAÑOS FÍSICO, PERDIDA O MENOSCABO QUE PUEDAN INCURRIR O SUFRIR, INCLUYENDO PERO NO LIMITÁNDOSE A DAÑOS FÍSICOS PERSONALES, MOLESTIAS, DOLOR, DAÑOS MORALES, INCAPACIDAD, PARÁLISIS, MUERTE, ANGUSTIA MENTAL O DAÑOS PATRIMONIALES, CAUSADOS O RELACIONADOS EN CUALQUIER FORMA CON LA ACTIVIDAD, INCLUYENDO SI LOS MISMOS SURGEN POR LA NEGLIGENCIA DE LAS PARTE INDEMNIZADAS U OTRAS. LAS PARTE RENUNCIANTES DE MANERA EXPRESA LIBERAN Y SACA EN PAZ Y A SALVO AL FORT WORTH INDEPENDENT SCHOOL DISTRICT Y A SUS PRECESORES, SUCESORES, PADRES, SUBSIDIARIAS, OFICIALES, DIRECTORES, EMPLEADOS, AGENTES, REPRESENTANTE, VOLUNTARIOS, ABOGADOS, ASEGURADORAS, AFILIADAS, ENTIDADES ASOCIADAS Y CAUSAHABIENTES DE CUALQUIER RECLAMO, ACCIÓN, CAUSA ACCIONABLE, DAÑO, GASTO, COSTO O RESPONSABILIDAD DE CUALQUIER TIPO (LA “PERDIDA”) RELACIONADA O DERIVADA DE LA ACTIVIDAD, INCLUYENDO PERO NO LIMITÁNDOSE A CUALQUIER COSTO ASOCIADO DE VIAJE Y/O ACOMODACIONES PREPARATORIAS ANTES, DURANTE O DESPUÉS DE LA ACTIVIDAD, SIN IMPORTAR SI RESULTAN POR LA NEGLIGENCIA DEL ESTUDIANTE, LA NEGLIGENCIA DE CUALQUIER PARTE INDEMNIZADA O CUALQUIER TERCERO O CUALQUIER OTRA CAUSA.
I've read the above and agree.
Virtual Waiver
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Dancing and the exercises associated with it may place unusual stresses on the body and may increase the risk of injury. Please make sure you always dance in a safe place. By allowing myself (if no longer a minor) and/or my child to participate in Texas Ballet Theater's online dance classes, I assume the risk of participation and agree that Texas Ballet Theater shall not be liable in any way for injuries or loss/damage of personal property sustained during participation in Texas Ballet Theater's online dance classes or any of their related functions. This assumption of risk and release of claims is given on my own behalf if I am the participant and on behalf of my child and myself, if my child is the participant, and extends to executors, administrators, heirs and assigns.
Bailando y los ejercicios hecho para aprenderselo pueden poner estres excepcional en el cuerpo y se puede lesionarse. Haz cuidado con el lugar y que haya espacio suficiente para bailar. Participando en las online clases de Texas Ballet Theater yo asumo el riesgo para mi hijo/mi hija y estoy de acuerdo que Texas Ballet Theater no sera responsable en ninguna manera para lesiones, perdidas o dano durante las clases. Estoy de acuerdo y doy la Asuncion de riesgo y liberacion de responsabilidad para mi hijo y yo mismo, si mi hijo es la participante, y eso extiende a los administradores y derechohabientes.
I've read the above and agree.
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