Summer Dance Camp We are excited to announce our very first SUMMER DANCE DAY CAMP for children 5-10 years old. REGISTER EARLY AND GET YOUR BOARDING PASS FOR THE ULTIMATE DANCE ADVENTURE BEFORE THEY ARE ALL GONE! MONDAY, JULY 11 - FRIDAY, JULY 15, 2022 DISNEY CRUISE SHIP THEME Drop off at a new port everyday and learn to dance in different genres to your favourite Disney songs. Cost: $180/Ship Mate (inc. tax) Bring your own lunch and snacks. Before/After care available for an additional cost Name Dancer's First Name * Dancer's Last Name * Birth Date * Age * Parent/Guardian Name * Email Address * Phone * Allergies Medications Health card number * Special notes we should know Before or after care needed? Yes No Who will drop off and pick up? SUMMER CAMP PRICE: SUMMER CAMP - JULY 11-15th Summer Camp July 11th-15th - $180.00 inc. tax * Must select for total PLEASE SELECT SUMMER CAMP BEFORE & AFTER CARE REQUIREMENTS Before Care July 11th Early Drop Off July 11th - $10.00 inc. tax Drop Off time July 11th BeforeCare July 12th Early Drop Off July 12th - $10.00 inc. tax Drop Off time July 12th Before Care July 13th Early Drop Off July 13th $10.00 - inc. tax Drop Off time July 13th Before Care July 14th Early Drop Off July 14th - $10.00 inc. tax Drop Off time July 14th Before Care July 15th Early Drop Off July 15th - $10.00 inc. tax Drop Off time July 15th AfterCare July11th After Care July 11th - $10.00 inc. tax Pick up time July 11th After Care July 12th After Care July 12th - $10.00 inc. tax Pick up time July 12th After Care July 13th After Care July 13th - $10.00 inc. tax Pick up time July 13th After Care July 14 After Care July 14th - $10.00 inc. tax Pick up time July 14th After Care July 15th After Care July 15th - $10.00 inc. tax Pick Up time July 15th AMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITY Participant's Name: Waiver discription BY CHECKING THIS BOX AND PARTICIPATING IN ANY NO LIMITS YOUTH PROGRAMS, I AGREE TO THE FOLLOWING STATEMENT/WAIVER: In Consideration of being allowed to participate in any way in the ABOVE, related events and activities, the undersigned acknowledges, appreciates and agrees that; 1. The risk of injury from the activities involved in this program is possible and can take place. While there are par5cular rules, equipment, and personal discipline that may reduce the risk; the risk of serious injury does exist; and, 2. I or participant KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participant; and, 3. I or participant willingly agree to comply with the stated and customary terms and condi5ons for participants. If however I or participant observe and feel there is a significant hazard during the presence or participti5on, I or participant will remove myself, or his/herself from participation and ring such to the attention of the nearest official immediately; and, 4. I, for myself or participant and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS No Limits Youth Organization, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and , if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I have read this Release of Liability and Assumption of Risk Agreement, and fully understand its terms. I understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any encouragement. PICTURE/PRINT/VIDEO MEDIA Picture, Print or video permission BY CHECKING THIS BOX AND PARTICIPATING IN ANY NO LIMITS YOUTH PROGRAMS, I AGREE TO THE FOLLOWING STATEMENT/WAIVER: I grant permission to No Limits Youth Organization to display photographs/video and/or name of the above named participant in media releases, displays, and other publications or social media. This consent will remain valid for as long as the individual remains involved with No Limits Youth Organization unless revoked in writing. HEALTH Please list any allergies, medications and/or conditions that we should know about : ASSISTED PAYMENTS ARE AVAILABLE, contact The Children’s Foundation (Playing For Keeps) and/or Canadian Tire (JumpStart) if you wish to apply for these payment sources. Do you plan on applying for assisted payments? Yes No Payment Confirmation TO COMPLETE REGISTRATION, I understand I must send an etransfer to info@nolimitsyouth.ca for the above amount. The full payment will confirm space is held for my athlete. If payment is not received, No Limits Youth cannot guarantee a space will be held. Payment Confirmation I UNDERSTAND, NO LIMITS YOUTH CANNOT OFFER REFUNDS once classes have started. Costumes are not included in our fees, details will be provided by instructors in January. Total Cost Total: $ All taxes are included in this price.