Local Camp Registration

You will need to fill out a form for EACH dancer that you are registering.

Dancer Information

Citizenship *

Canadian
Ukrainian

Dancer Name *

First

Last

Dancer Date of Birth (MM/DD/YYYY) *

Dancer T-Shirt Size

PROMO Code - Enter BEFORE choosing camp below

Promo code are case sensitive - if your promo code does not apply, please ensure you are using a proper code. Discounts will not be applied after the fact.

Choose a Cheremosh Dance Camp - PLEASE CHOOSE CAREFULLY *

Beginner 4-6yrs Aug 6-9 - $150.00
Intermediate 7-10yr Aug 12-16 - $300.00
Advanced 11+ Aug 19-23 - $300.00

Early/late pickup from 8:00AM-4:30PM for $10/day for Intermediate and Advanced Camps

Parent Information

Parent Name *

First

Last

Parent Email *

Confirm Email

Permission to use Email for Distribution *

*Email will NOT be shared, only used for correspondence related to society matters.

Parent Phone Number *

Parent Secondary Phone Number

Permission to use Dancer(s) photographic likeness *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Payment

I have read and agree to the Terms of Registration at the TOP of this page: *

I have read and agree to the Terms of Registration at the TOP of this page:

I understand I will be responsible for the cost of any banking transactions should I need to withdraw *

I understand I will be responsible for the cost of any banking transactions should I need to withdraw

Liability Release Form and Assumption of Risk *

I have read and agree to the Liability Release Form and Assumption of Risk listed below.

I/we realize that participation in dance classes and activities could result in some possible personal injury. Despite precautions being taken by the studio, accidents and injuries may occur. By signing this release form, I/we (the dancer and parent/guardian) assume ALL risks related to the use of any and all spaces used by Ukrainian Cheremosh Society.

I/we agree to release from responsibility the Ukrainian Cheremosh Society, including all teachers, dancers, staff members, volunteers, and facilities, used by Ukrainian Cheremosh Society from any cause of action, claims or demands now and in the future. I/we will not hold Ukrainian Cheremosh Society, liable for any personal injury including but not limited to scrapes, bruises, cuts, sprains, fractures, broken bone, concussions or death or any personal property damage/loss, which may occur on the premises before, during or after classes.

I understand that Ukrainian Cheremosh Society, are licensed, accredited and insured organization. In the event that I/we should observe any unsafe conduct or condition before, during or after my/our classes, I/we agree to report the unsafe conduct or conditions to the dance instructor, president of the society, staff or volunteer members as soon as possible.

COVID-19 – I/we agree that I/we will follow all safety procedures put in place by Ukrainian Cheremosh Society to reduce risk of infection. If a family member or student should display any symptoms, I/we will ensure they do not attend class, only returning once the isolation period has ceased.
Photography/Video – I give permission for my child’s photographs/videos to be used for publicity and advertising in the studio, on Ukrainian Cheremosh Society website and in the community.

Furthermore, I/we agree to obey the class and facility rules and take full responsibility for my/our behavior in addition to any damage I/we may cause to the facilities utilized by Ukrainian Cheremosh Society, including but not limited to performance competition theatres/venues.

Signature *

Clear Signature

By signing this I acknowledge that I have read and agree to the Liability Release Form and Assumption of Risk listed above.

Total

$0.00

Payment Method *

Credit Card

Local Camp Registration

Cheremosh Local Camp Registration

Please read ALL information

Dancer Information

Parent Information

Payment

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