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Summer 2013
Summer Schedule Newberg
Summer Schedule McMinnville
Register For Summer Here
Summer Camp Schedule
Camp Registration Form
Summer Policies
Summer Dress Code
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Class Descriptions
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About Us/Mission
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Newberg
Newberg Schedule Fall 2012 – Spring 2013
Online Registration Form
PC Page
Competitions/Conventions
Requirements/Policies
Class Descriptions
Tuition Info and Policies
Handouts Newberg
McMinnville
Mac Schedule Fall 2012 – Spring 2013
Online Registration Form
Class Descriptions
Tuition Info and Policies
Handouts Mac
Info
Calendar
Policies
Dress Code
Contact Us
Register For Summer Here
Registration is open!
Register to reserve your spot for our 9 week summer session.
2013 Summer Registration Form
Fill out the form below carefully and be sure to fill all required fields to avoid having to re-enter it all again. Submit individual registration forms for each dancer in your family.
Select location
*
Newberg
McMinnville
Both
Dancer Info
Dancer Name
*
First
Last
Gender
*
Female
Male
Birthday
*
Dancer Phone # (for closure and placement notification)
*
Phone format: (###)###-####
Dancer Email (for important info)
*
Please choose an email that is checked on a regular basis
Mailing Address
*
Street Address
Address Line 2
City
State / Province
Zip / Postal Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Parent Info
Parent #1 Name
*
First
Last
Parent #1 Phone
*
Phone format: (###)###-####
Parent #1 Email
*
Billing Address (if different than dancer address)
Street Address
Address Line 2
City
State / Province
Zip / Postal Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Country
Parent #2 Name
First
Last
Parent #2 Phone
Phone format: (###)###-####
Parent #2 Email
Medical
Does your dancer have any medical needs, allergies, or other considerations?
*
No, none that we know of
Diabetic
Heart murmur
Allergies we should know about
IEP or other learning considerations
Other
If you selected anything other than 'no' to the question above, please expand on your answer here
Emergency Contact
*
First
Last
Emergency Contact Phone
*
Phone format: (###)###-####
Classes
Monday Classes
List classes in the same format as the schedule i.e. 3:00 - 4:00 Int. Ballet KP and separate them by line
Tuesday Classes
List classes in the same format as the schedule i.e. 3:00 - 4:00 Int. Ballet KP and separate them by line
Wednesday Classes
List classes in the same format as the schedule i.e. 3:00 - 4:00 Int. Ballet KP and separate them by line
Thursday Classes
List classes in the same format as the schedule i.e. 3:00 - 4:00 Int. Ballet KP and separate them by line
Please list your dance experience
*
Specific goals
*
Improve technique
Improve flexibility
Learn a new sport
Join a performing company and compete
Improve physical fitness
Build a more positive self-image and self-confidence
Potentially dance on a cheer or dance team
Potentially dance in college or as a career
Please select all of the options that best describe your dancer's goals and your goals.
How did you hear about us?
*
Website/Internet Search
Facebook or Twitter
Free class card
Bring-A-Friend Week
Drove by CVDA location
Chamber of Commerce
Referral (please list name below)
Other (please explain below)
If you selected referral or other in the question above, please explain below
Payment
Payment Options
*
In full with registration fee discount
1st month with registration fee
Registration fee only
Dancers that performed in the 2013 Annual Showcase at CVDA pay a $9 registration fee with a family reg. fee of $15. All other dancers pay $15 registration fee (families pay $25 total) unless registering and paying in full before the first class of the session. We will email you tuition totals within 3 - 5 days of your registration. Tuition is calculated per the tuition policies.
Tuition Payment Type
*
Cash/Check/Post dated checks
Automatic debit/credit monthly
Monthly billing ($10 additional charge per month)
I have read and agree to the tuition, dress code, and studio policies
*
Yes
No
Do you give CVDA permission to use your dancer's image for marketing and promotional materials?
*
Yes, I give permission
No, I do not give permission
Names will NOT be used without permission.
I have read and agree to the liability waiver
*
Please read and type your full name into the signature line above if you agree to the terms: I agree to release and hold harmless Chehalem Valley Dance Academy, All Star Dancewear, and anyone providing services for Chehalem Valley Dance Academy or All Star Dancewear from any and all claims of any nature, including, but not limited to property lost, personal injury, or death. I agree to release Chehalem Valley Dance Academy from all claims that might occur at their annual showcase or any othe CVDA event my dancer may be participating in. I understand that teachers may physically adjust my dancer's placement. I will not leave my child under the age of 10 unaccompanied in the lobby, in All Star Dancewear, or outside on the benches of CVDA.
BEFORE SUBMITTING
BE SURE TO HAVE FILLED OUT EVERY SELECTION WITH AN ASTERISK OR IT WILL NOT SUBMIT AND YOU WILL HAVE TO ENTER IT ALL YOURSELF AGAIN. THIS FORM DOES NOT REMEMBER INFORMATION.
Dates that you will be gone this summer?
If you know the dates that your dancer will be at camp, or on a family vacation, please let us know here! We will let your dancer's teacher know.
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