The LaVilla School of the Arts - Duval County Public Schools
The LaVilla School of the Arts - Duval County Public Schools
The LaVilla School of the Arts - Duval County Public Schools
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<strong>The</strong> <strong>LaVilla</strong> <strong>School</strong> <strong>of</strong> <strong>the</strong> <strong>Arts</strong>’<br />
Dance<br />
Department<br />
Director: Michelle Ottley-Fisher<br />
Co-Chair: Susan Jennings<br />
501 North Davis Street<br />
Jacksonville, Florida 32202<br />
(904) 633-6069 ext. 179 or 127<br />
Dance booster website www.lasotadance.com<br />
Welcome Dancers and Parents,<br />
to <strong>the</strong> <strong>LaVilla</strong> <strong>School</strong> <strong>of</strong> <strong>the</strong> <strong>Arts</strong>’ Dance Department. <strong>The</strong> information in<br />
this packet is designed to answer most, if not all, <strong>of</strong> your questions about our<br />
program. We’ll also be using it to ga<strong>the</strong>r information about you. To this end we<br />
ask that you be sure to read through this packet very carefully and return <strong>the</strong><br />
necessary forms in this packet by <strong>the</strong> dates indicated. If, however, you still have<br />
any questions or concerns, call us at 633-6069 ext 118 or ext 127. Don’t be<br />
discouraged by <strong>the</strong> answering machine. Most <strong>of</strong>ten it’s our only indication that<br />
you’ve called. Once again, welcome and let’s look forward to an incredible new year.
Our Mission:<br />
<strong>The</strong> dance department at <strong>the</strong> <strong>LaVilla</strong> <strong>School</strong> <strong>of</strong> <strong>the</strong> <strong>Arts</strong> strives<br />
towards <strong>the</strong> same end for all <strong>of</strong> our dancers; to expose all dancers to and<br />
educate <strong>the</strong>m in a variety <strong>of</strong> technical dance styles, primarily ballet, but also<br />
to include jazz and modern dance techniques; to enhance <strong>the</strong>ir basic tactile<br />
development with fur<strong>the</strong>r training in tap, hip-hop, choreography and dance<br />
history and current knowledge; and finally, to encourage a more aes<strong>the</strong>tic<br />
awareness <strong>of</strong> dance through such necessary extras as guest artists, field trips,<br />
workshops, and performance opportunities.<br />
To ensure that all dancers enjoy <strong>the</strong> maximum benefit from this program<br />
dancers are placed into classes based on technical level and not be age or<br />
grade. Achievement to <strong>the</strong> next level, <strong>the</strong>n, comes after strong technical<br />
advancement and increased discipline and not necessarily because <strong>of</strong> grade<br />
level advancement.<br />
Our philosophy <strong>of</strong> learning revolves around enhancing and structuring <strong>the</strong><br />
dancer’s training to lead towards a true appreciation, if not a continued<br />
study, <strong>of</strong> dance. Rest assured <strong>the</strong>n that everything that we ask <strong>of</strong> your<br />
dancer is towards this goal. We hope that you would expect no less <strong>of</strong> us.<br />
We also hope to develop a trusting, positive and nurturing environment for<br />
all involved. In short… have a great time!<br />
Thank You,<br />
<strong>The</strong> <strong>LaVilla</strong> <strong>School</strong> <strong>of</strong> <strong>the</strong> <strong>Arts</strong> Dance Faculty
<strong>The</strong> <strong>LaVilla</strong> Dance Department Dress Code<br />
*** (PLEASE LABEL ALL SUPPLIES WITH DANCER’S LAST NAME AND FIRST INITIAL)<br />
See information for ladies on <strong>the</strong> left and information for gentlemen on <strong>the</strong> right<br />
Ladies: ______________________________Gentlemen:<br />
Ballet<br />
o 2 Black Leotards (any sleeve style) 2 Solid White T-shirts<br />
o 2 Pairs <strong>of</strong> Pink Tights 2 Pairs <strong>of</strong> Black Tights<br />
o Pink Ballet Slippers Black Ballet Shoes<br />
Plus...<br />
**Tights may be full footed or convertible. ** Men‟s tights must have a black center<br />
** Dance Levels 5-8 will need pointe shoes **Dance Levels 7-8 also need White<br />
** Dance Levels 7-8 also need seamed pink tights Tights and White Ballet Shoes<br />
Hair must be in a bun for ballet classes ( See HairNotes on <strong>the</strong> next page)<br />
Jazz<br />
o Solid Color Leotard Solid Color T-Shirt<br />
o Tan Tights Black Dance Pants<br />
o Tan Jazz Shoes Black Jazz Shoes<br />
Hair must be <strong>of</strong>f face, neck and ears for jazz and modern classes ( See HairNotes on <strong>the</strong> next page)<br />
Plus...<br />
**Any Slip-on or Lace up style shoes acceptable SEE INFORMATION TO THE LEFT<br />
** No sneakers for class, please. You’ll have a sneaker opportunity with Hip-Hop workshops<br />
**Tights must be convertible<br />
Modern<br />
o Black Leotard Black T-shirt<br />
o Black Footless Tights Black Dance Pants<br />
Plus...<br />
Ladies Must Also Have Gentlemen Must Also Have<br />
o A small dance bag A small Dance Bag<br />
o A black or flesh colored sports bra A flesh-toned dance belt<br />
o A flesh-toned camisole A 2” black headband if nec.<br />
o A supply <strong>of</strong> hair ties and pins<br />
o A 2” thick black headband if short hair<br />
Undergarments may not be worn beneath dance attire.<br />
Ladies we’ll talk about options to undies<br />
Please wait until fur<strong>the</strong>r notice before purchasing Tap shoes or Pointe shoes<br />
for levels o<strong>the</strong>r than <strong>the</strong> ones indicated. At that time Tap shoes will have to be tan<br />
for <strong>the</strong> ladies and black for <strong>the</strong> gentlemen. <strong>The</strong> dance department allows cover-
ups during <strong>the</strong> Winter Season for <strong>the</strong> warm-up portion <strong>of</strong> class. Acceptable covers<br />
are ballet skirts, dance pants, dance sweaters, sweat pants and leg-warmers.<br />
<strong>LaVilla</strong> Dance Supply and Wish List<br />
<strong>The</strong>se items are products to aid <strong>the</strong> dancer in being successful in <strong>the</strong> academic portion<br />
<strong>of</strong> <strong>the</strong>ir dance experience here at <strong>LaVilla</strong>. Some o<strong>the</strong>rs are to help us all remain<br />
healthy and organized, which will also help us to be successful.<br />
All dancers will need to have:<br />
� A school issued planner (<strong>The</strong> planner will be used daily and should be checked<br />
every Friday for handouts, calendars, returned work and grading information.)<br />
� A 1 inch White 3 ring binder with pockets<br />
o <strong>The</strong> binder needs to have <strong>the</strong> clear windows on <strong>the</strong> outside as well as<br />
pockets<br />
� One folder with pockets and binder holes<br />
� A pocket ballet dictionary<br />
� A book for reading (anything dance; fiction or non-fiction, hard or s<strong>of</strong>t back)<br />
� A pencil bag with binder holes<br />
� 1 package <strong>of</strong> pencils<br />
� 1 package <strong>of</strong> pens<br />
� <strong>The</strong> special extra indicated below based on your class level indicated on<br />
your schedule.<br />
Dance 1 & 2: Multicolor Construction paper and/or Band Aids<br />
Dance 3 & 4: One pack <strong>of</strong> copy paper (white or color) and/or Loose Leaf Paper<br />
Dance 5 & 6: 2 packages <strong>of</strong> #2 pencils and/or Band Aids<br />
Dance 7 & 8: A small supply <strong>of</strong> blank CDR-Music and/or DVD discs<br />
You Can Also Help Us Greatly With <strong>The</strong> Following Supplies<br />
� 1 large container <strong>of</strong> disinfecting wipes<br />
� 1 bottle <strong>of</strong> hand sanitizer<br />
� 2 Glade Plug-In Scented Oil<br />
� 2 boxes <strong>of</strong> facial tissues<br />
� 1 small container <strong>of</strong> liquid laundry detergent<br />
� 1 package <strong>of</strong> paper towels<br />
� 1 mesh laundry sack or plastic storage container (any size)<br />
� 2 boxes <strong>of</strong> bandages<br />
� 1 tube <strong>of</strong> Benedryl/anti-allergy ointment ( no donation needed at this time)<br />
� 1 re-freezable ice pack<br />
Thank you for considering our wishes
HAIRNOTES<br />
For all dance classes, <strong>the</strong> dancer’s hair must be secured <strong>of</strong> <strong>the</strong> face, neck and<br />
ears. For <strong>the</strong> ballet class it is required that <strong>the</strong> female dancer wear <strong>the</strong> hair in a<br />
clean, secure bun.<br />
o <strong>The</strong> bun must be wrapped, pinned and gelled, if necessary to eliminate<br />
wisps, bangs, falls, or curls about <strong>the</strong> face and neck.<br />
o If <strong>the</strong> dancer‟s hair is comparatively short and cannot be pulled back<br />
into a tie or elastic, it is <strong>the</strong>n required that <strong>the</strong> hair be held by a 2” thick<br />
black headband. This rule applies to both ladies and gentlemen.<br />
(Gentlemen are not required to wear a bun; however, measures must be taken to<br />
create a clean, secure style).<br />
o For all o<strong>the</strong>r classes, <strong>the</strong> hair may be worn in a clean ponytail without<br />
distractions, but a bun is always more preferred.<br />
<strong>The</strong> <strong>LaVilla</strong> dance department will accept braid styles that strictly meet with<br />
<strong>the</strong> following guidelines. Please be sure to follow <strong>the</strong>m closely to avoid grade<br />
reduction.<br />
o Braids must be no larger than a medium size (no thicker than a<br />
kindergarten pencil)<br />
o Braids must be a length that can be easily pulled up into a bun. (We<br />
suggest no longer than shoulder blade.)<br />
o Cornrows, Twist, or Shreds, Curly Braids, even Afro puffs are allowed.<br />
o Braids must be maneuverable enough to secure in a neat “chignon” style<br />
bun <strong>of</strong>f <strong>the</strong> face, neck and ears.<br />
o <strong>The</strong>re should be no portion <strong>of</strong> <strong>the</strong> braid style that cannot be secured in<br />
<strong>the</strong> bun<br />
*In support <strong>of</strong> maintaining a healthy hair style, please ask stylists not to pull<br />
braids too tightly at <strong>the</strong> starting points<br />
Be sure that hair adornments are not distracting, hindering to movement or a<br />
potential hazard.
Ballet Shop<br />
799 Blanding Blvd. (Orange Park)<br />
(904)276-5992<br />
Dance „n‟ Stuff Boutique<br />
8011-3 Merrill Road (Arlington)<br />
743-6080<br />
1368 Beach Blvd (Beaches<br />
(904)247-8006<br />
Danskin Outlet<br />
5080 International Drive<br />
Orlando, Florida 32819<br />
(407) 351-2364<br />
Julian‟s dancewear<br />
9825 San Jose’ Blvd #31<br />
(904) 880-0111 (San Marco/Mandarin)<br />
Make Believe Costumes & Dancewear<br />
1855 Parental Home Road (Southside)<br />
645-6337<br />
10950 San Jose’ Blvd. (Mandarin)<br />
880-2288<br />
Ultimate Dancewear & Accessories<br />
9560 Lem Turner Road (Northside)<br />
(904) 766-0009<br />
Willie‟s For Kids<br />
3567 St. John’s Avenue<br />
(904) 384- 3664 (Avondale)<br />
Inexpensive Online options<br />
Local Dancewear Establishments<br />
www.onlinedancewear.com www.justforkix.com<br />
www.discountdancesupply.com www.dancewearsolutions.com
www.allaboutdance.com<br />
Also try your local Target, Wal-Mart, or Payless<br />
Grading Policies<br />
<strong>The</strong> dancer’s grade is dependant on three major factors: 1) his/her daily participation/<br />
success with performance guidelines & 2) his/her individual advancement in dance<br />
technique and performance and 3) his/her quarterly success with written work and<br />
standards achievements.<br />
1) <strong>The</strong> Participation Grade will include points accrued each day for<br />
o Timeliness to <strong>the</strong> studio from <strong>the</strong> dressing rooms<br />
o Proper attire based on <strong>the</strong> technique being taught<br />
o Proper shoes based on technique being taught<br />
o Proper hair based on technique being taught<br />
o Overall classroom participation and technical development<br />
Since this is a performance art, <strong>the</strong> participation grade will also reflect <strong>the</strong> dancer’s displayed level <strong>of</strong><br />
intent, focus, discipline, respect and <strong>the</strong> dancer’s self-motivation and commitment to advance.<br />
Although fairly subjective, this is a very specific area <strong>of</strong> assessment. This section <strong>of</strong> <strong>the</strong> participation<br />
grade is an average <strong>of</strong> each regular dance instructor that that dancer meets with.<br />
**IMPORTANT<br />
When you just can‟t dance<br />
o Please return a parent/guardian written and signed note when <strong>the</strong> dancer is too ill<br />
or injured to dance.<br />
o After three days, <strong>the</strong> excuse note must be physician-issued.<br />
o Dancer’s will be asked to complete make-up classes after three absences or nondressed<br />
days (excused or unexcused)<br />
o Dancer’s will be required to complete a written make-up assignment if injury or<br />
illness extends past 7 days and must be able to pass <strong>the</strong> quarter final according to<br />
county rules.<br />
o Unexcused non-dressed days will result in a loss <strong>of</strong> half- <strong>of</strong> <strong>the</strong> daily points when a<br />
written assignment is completed correctly and returned with a parent’s signature.<br />
o 5 unexcused non-dress days will result in an automatic failing grade<br />
2) <strong>The</strong> Dance Advancement Grade is dependant on <strong>the</strong> student’s individual work<br />
ethic and advancement. This grade will be an average <strong>of</strong> Teacher assessments<br />
from each instructor that <strong>the</strong> dancer sees.<br />
3) <strong>The</strong> Written Grade will assess points earned from vocabulary worksheets,<br />
quizzes, tests, “Dance News Assignments” (DNA’S) and final exams. DNA’s are<br />
week long, research assignments based on a specific area <strong>of</strong> dance development.<br />
<strong>The</strong> final exams may be written, practicum (movement) or oral.
**Please understand that it is important to <strong>the</strong> growth <strong>of</strong> a dancer to know <strong>the</strong> history, current events<br />
and information that affects a dancer. It is also imperative to be able to express oneself in writing.<br />
We‟ve chosen this standard to support your academic standing.<br />
<strong>The</strong> Dance Enrichment Fee<br />
(DEF)<br />
<strong>The</strong> Dance Enrichment Fee is a yearly fund that is donated by <strong>the</strong> dancers and<br />
<strong>the</strong>ir parents to help cover expenses incurred by <strong>the</strong> dance department. <strong>The</strong>se<br />
expenses include guest artist classes, choreographer fees, workshop fees, costuming,<br />
field trips, transportation, performance security, make-up class instruction, and even<br />
some equipment, travel, s<strong>of</strong>tware and supplies<br />
<strong>The</strong>se extras do so much to enhance <strong>the</strong> quality <strong>of</strong> learning that we’ve come to<br />
expect <strong>the</strong>m and <strong>the</strong>y are invaluable in <strong>the</strong>ir capacity. <strong>The</strong>y do come with a hefty<br />
tag. To costume an average class <strong>of</strong> 25 dancers it could <strong>the</strong>oretically cost $1,300.<br />
We have 8 levels <strong>of</strong> classes. Just one guest can run $ 100 a workshop/class. If<br />
choreography is involved, an added $500-$800 is required just for <strong>the</strong> rights to <strong>the</strong><br />
choreography. <strong>The</strong>n <strong>the</strong>re is usually rehearsal time, and travel/room/board.<br />
So you see, and I’m sure many <strong>of</strong> your already know, dance is an expensive art<br />
form. Your DEF is just about all we have. We will also be <strong>of</strong>fering fundraisers<br />
through <strong>the</strong> dance booster organization and <strong>the</strong> dance department. Some<br />
fundraisers will go to <strong>the</strong> general fund, and o<strong>the</strong>rs to <strong>the</strong> dancer’s individual<br />
account for class-specific events.<br />
o <strong>The</strong> DEF can be paid all at once or in installments at Orientation, <strong>the</strong><br />
Meet & Greet, Open House or at <strong>the</strong> September, October and<br />
November Booster Meetings.<br />
o <strong>The</strong> DEF should be covered in its entirety by <strong>the</strong> November Booster<br />
Meeting<br />
o A separate handout <strong>of</strong> <strong>the</strong> Enrichment Fee will be supplied<br />
Dance Levels 1 & 2 (first period)- $50<br />
Dance Levels 3 & 4 (second period) -$75<br />
Dance Levels 5 & 6 (third period) -$125<br />
Dance Levels 7 & 8 (fourth period) -$150<br />
If we are unable to receive your dancer‟s DEF payment<br />
o Your dancer will not earn a costume for any dance department concert<br />
o Your dancer will not be able to participate in payment based<br />
workshops/field trips or activities
o Your dancer will not be able to collect his/her yearbook<br />
O<strong>the</strong>r Important Information<br />
Performing:<br />
All dancers in <strong>the</strong> department are invited to perform in <strong>the</strong> Spring Dance<br />
Concert which closes out our dance year with a bang! We also will be hosting,<br />
new this year, a Fall Concert Showing, Building Dances Showing and <strong>the</strong> annual<br />
Guest Artist Concert. Details on <strong>the</strong>se three concerts will be discussed later.<br />
<strong>The</strong>re are also o<strong>the</strong>r open or class-level workshop or performance opportunities.<br />
<strong>The</strong> dancer’s will be made aware <strong>of</strong> this information ahead <strong>of</strong> time. <strong>The</strong> dancer<br />
must maintain a GPA <strong>of</strong> 2.0 for <strong>the</strong> quarter in order to perform, but is not<br />
penalized fur<strong>the</strong>r if <strong>the</strong>y are restricted. In most cases <strong>the</strong> dancer will be allowed<br />
<strong>the</strong> opportunity to participate in <strong>the</strong> concert in ano<strong>the</strong>r capacity and receive<br />
performance extra credit along with his/her peers.<br />
All dance concert begin at 7:30pm and will have a call time <strong>of</strong> 6:00pm.<br />
<strong>The</strong> Tap Ensemble:<br />
This is an after-school performance ensemble made up <strong>of</strong> students from any<br />
arts area who are pr<strong>of</strong>icient if tap dancing and performance. This ensemble will<br />
meet weekly to learn choreography and in a variety <strong>of</strong> tap styles. <strong>The</strong> student will<br />
need to audition for <strong>the</strong> ensemble and will be required to sign a contract for<br />
participation. This is not a tap class. <strong>The</strong> dancers will be <strong>of</strong>fered tap technique<br />
classes beginning at Dance Level 3.<br />
Menzklub<br />
This after school group is open to all dancers and is a mandatory class for all<br />
<strong>the</strong> gentlemen in <strong>the</strong> dance department. Here, <strong>the</strong> gentlemen focus on male<br />
dance development, partnering techniques, and strength training not tackled<br />
in <strong>the</strong> regular dance class. It is averaged into <strong>the</strong> class grade and is imperative<br />
to <strong>the</strong> proper movement-growth <strong>of</strong> <strong>the</strong> male dancer.<br />
Dance Ensemble 7 and <strong>the</strong> Dance Repertoire Ensemble (Level 8)<br />
<strong>The</strong> dancers in block 4 have auditioned for placement at this level and have<br />
displayed pr<strong>of</strong>iciency in ballet, pointe, modern and jazz dance techniques. All<br />
dancers in this level must also maintain a 2.0 overall GPA and a 3.5 Dance GPA.<br />
<strong>The</strong> Dance Repertoire Ensemble are those selected for Dance Level 8. <strong>The</strong>y serve<br />
as ambassadors to <strong>the</strong> department and meet weekly for mandatory repertoire<br />
work and rehearsals.
<strong>The</strong> Dance Department Booster Volunteer Form Part 1<br />
<strong>The</strong> Dance Booster Organization is an association <strong>of</strong> parents, businesses and o<strong>the</strong>r<br />
friends <strong>of</strong> <strong>the</strong> <strong>LaVilla</strong> Dance Department whose primary focus is to assist in <strong>the</strong><br />
many ways that improve <strong>the</strong> quality <strong>of</strong> <strong>the</strong> <strong>LaVilla</strong> dance experience. <strong>The</strong> Club<br />
follows booster and school organizational guidelines. <strong>The</strong>re are so many ways to<br />
get involved with your dancer’s time here at <strong>LaVilla</strong> and we can think <strong>of</strong> many<br />
more. Please consider a commitment <strong>of</strong> 2 hours a month and volunteering in at<br />
least one dance event this year. If we can get that from just one parent per dancer<br />
we could accumulate approximately 400 “man-hours” and invaluable memories.<br />
Speaking <strong>of</strong> commitment, take a look at what we have below and don’t forget to fill<br />
out <strong>the</strong> district volunteer form<br />
Active Booster Membership Commitment Statement<br />
If you’re really ready to jump into <strong>the</strong> dance year here at <strong>LaVilla</strong>? <strong>The</strong>n put on<br />
those running shoes and let’s hit <strong>the</strong> ground! <strong>The</strong> dance booster organization<br />
really needs you and most importantly we need your time, expertise and services.<br />
Below you’ll find a listing <strong>of</strong> <strong>the</strong> many activities and events that we try to <strong>of</strong>fer<br />
<strong>the</strong> dancers, but so many <strong>of</strong> <strong>the</strong> events are not even possible without your helping<br />
hand. So, we’re not only asking that you consider volunteering, but that you make<br />
a specific decision to help and where you’d like to help. To help you make your mind<br />
up quickly we’d like to <strong>of</strong>fer you a little incentive.<br />
1) Each household will receive a $5 commitment waiver <strong>of</strong>f <strong>the</strong> DEF simply for<br />
volunteering and committing your time and or expertise to a dance booster<br />
activity.<br />
2) <strong>The</strong>n, if your enrichment fee is covered by or before September 30th, your<br />
dancer can receive a $10 credit towards ei<strong>the</strong>r <strong>the</strong> Manhattan Dance Project<br />
(October 9 th & 10 th ) or <strong>the</strong> Florida Dance On Tour (October 29 th -31 st ). Just let us<br />
know which.<br />
3) Dancers with siblings in currently in <strong>the</strong> department may also earn a 10%<br />
discount.<br />
So, c’mon make <strong>the</strong> commitment to make dance awesome for your dancer while<br />
<strong>the</strong>y’re at <strong>LaVilla</strong>. Ei<strong>the</strong>r way; you win and so does your child!
<strong>The</strong> Dance Department Volunteer Form Part II<br />
Please Fill out and Return by Sept 12th<br />
Level______ Grade______<br />
Dancer’s Name______________________________________________________<br />
Volunteer’s Name (s) __________________________________________________<br />
Contact Information: Daytime Phone ___________________<br />
Evening Phone___________________<br />
Cell/Pager Number________________<br />
Email Address (es) _________________________________<br />
I __________________ would like to <strong>of</strong>fer my time and/or services to my dancer<br />
by way <strong>of</strong> <strong>the</strong> positions, events, or activities indicated below and gladly reap <strong>the</strong><br />
dual benefits.<br />
Volunteer Areas <strong>of</strong> Interest:<br />
_____Annual Trip _____Concessions _____ Fundraising<br />
_____ Chaperoning _____Grant Writing/Business Partnerships<br />
_____ Phone Message/ Newsletter/Manager _____Merchandise<br />
_____ Costume Room _____ <strong>The</strong> Turkey Tick _____ Concerts<br />
_____ Events/Workshops _____ Historian<br />
_____ Office Manager _____Event Videographer/ Archiving
Thank you so much for your time and information. We<br />
will use all <strong>of</strong> it responsibly!<br />
Have a great year!<br />
<strong>The</strong> Dance Information Form<br />
Please Fill out and Return by Sept 12th<br />
Dance Level _______ Grade ________<br />
Dancer‟s Name _______________________________________________________<br />
Address _____________________________________________________________<br />
____________________________________________________________________<br />
Current Grade __________ Age __________ Date <strong>of</strong> Birth __________________<br />
Home Phone # _______________ Cell Phone # ________________<br />
Dancer‟s email address ________________________________________________<br />
Parent/ Guardian 1____________________________________________________<br />
Address______________________________________________________________<br />
_____________________________________________________________________<br />
Home Phone # __________ Work Phone # ___________Cell Phone # __________<br />
Parent/Guardian email addresses__________________________________________<br />
Parent/Guardian 2 _____________________________________________________<br />
Address ______________________________________________________________<br />
_____________________________________________________________________<br />
Home Phone # __________ Work Phone # ____________ Cell Phone # _________<br />
Dancer‟s Training Background ___________________________________________<br />
_____________________________________________________________________<br />
_____________________________________________________________________
_____________________________________________________________________<br />
Dance Enrichment Fee Payment Record<br />
Please fill out and return by Sept 12th<br />
Dancer’s Name _________________________ Dance Block________ Grade_____<br />
Enrichment Fee Amount $ ____________<br />
Parent/Guardian Name(s) ______________________________________________<br />
(please print)<br />
_________ Paid in one lump sum at Orientation, <strong>the</strong> Meet & Greet, Open House,<br />
September Booster, and October Booster, November Booster<br />
_________ Paid in Installments<br />
____________________, ______________________, and _____________________<br />
Sibling Name ___________________________ <strong>Arts</strong> Area _____________________<br />
**Please do not send cash in with your dancer.<br />
Signature <strong>of</strong> Parent/Guardian _________________________________ Date______<br />
You will receive a receipt with each payment. Please be sure to keep this for<br />
accounting purposes.<br />
--------------------------------------Do Not Write Below This Line---------------------------------<br />
Student _______________________Parent/ Guardian ________________________<br />
DEF<br />
1. ______________ $______________ # _________________<br />
2. ______________ $______________ # _________________<br />
3. ______________ $______________ # _________________<br />
4. ______________ $______________ # _________________
<strong>The</strong> Dance Blanket Permission Slip<br />
Please Return filled out by Sept 12th<br />
Level_____ Grade ______<br />
<strong>The</strong> following form will serve as a permission slip and medical emergency form to cover all field trip<br />
opportunities and activities that <strong>the</strong> dancer listed below will be invited to participate in with <strong>the</strong> <strong>LaVilla</strong><br />
Dance Department through <strong>the</strong> *2011-2014 school years. Informational forms will be sent home to allow for<br />
parental denial. Please read carefully.<br />
I _______________________ <strong>the</strong> parent/guardian <strong>of</strong> ________________________ do hereby give<br />
permission for this dancer to attend, perform with, be photographed or videotaped by or travel with <strong>the</strong> <strong>LaVilla</strong><br />
Dance Department to all dance related functions for which <strong>the</strong>y are eligible through <strong>the</strong> 2009-2012 school years. I<br />
understand that each activity and event may hold some level <strong>of</strong> physical risk as is expected in this art form. And<br />
do, <strong>the</strong>refore release <strong>the</strong> <strong>LaVilla</strong> <strong>School</strong> <strong>of</strong> <strong>the</strong> <strong>Arts</strong>, <strong>the</strong> dance department, faculty, volunteers, and o<strong>the</strong>r agents<br />
from any legal or financial responsibility or liability in <strong>the</strong> event <strong>of</strong> personal injury, illness, or property damage<br />
during said activities.<br />
In case <strong>of</strong> emergency, every attempt will be made to contact me or any listed emergency contact. I<br />
request that, by judgment <strong>of</strong> chaperones, director, faculty or medical personnel, measures be taken without delay<br />
to correct said illness or accidental injury. This is to say that chaperones, director, faculty or medical personnel<br />
may also transport injured or ill dancer to a medical facility if necessary.<br />
I understand that if any <strong>of</strong> <strong>the</strong>se situations should arise a report will be filed with <strong>the</strong> House<br />
Administration and Main Office. I am notified that I am financially responsible for expenses which may be<br />
incurred during emergency transportation or care.<br />
<strong>The</strong> following may be administered to my child by and adult or medical pr<strong>of</strong>essional<br />
_____Aspirin _____Antihistamines _____Acetametaphin _____ Antibiotics (topical)<br />
_____Antiseptics _____Antacids_____ Cough Drops _____Ibupr<strong>of</strong>en _____O<strong>the</strong>r (Specify Below)<br />
List allergies, conditions or Chronic Illnesses that we should be aware <strong>of</strong><br />
________________________________________________________________________________<br />
(please register all emergency medications in <strong>the</strong> proper areas in House Administration)<br />
Medical Emergency Information<br />
Primary Care Physician ________________________________ Phone Number __________<br />
Family Dentist _____________________________________ Phone ____________________<br />
Dancer’s home # _____________________<br />
Mo<strong>the</strong>r‟s Name ___________________________Work #_________________ Cell # _________________<br />
Fa<strong>the</strong>r‟s Name ___________________________ Work #________________ Cell #__________________<br />
Emergency Contact ____________________________________ Number _____________<br />
O<strong>the</strong>r Contact ____________________________________ Number __________________<br />
**PLEASE DO NOT SIGN UNTIL NOTARIZED. RETURNING DANCERS DO NOTNEED A NEW BPS, IF ON<br />
FILE FROM THE YEAR BEFORE.<br />
*Parent/Guardian Signature _____________________________________________<br />
(Please sign only in presence <strong>of</strong> a Notary <strong>Public</strong>)
Presented to and Sworn before me this ____ day <strong>of</strong> _____________ in <strong>the</strong> year_____<br />
Notary <strong>Public</strong> State <strong>of</strong> Florida ___________________________ Commission Expires _____