LB-Dance-App2133-Summer-2012-final2_LB 2133 ... - SportimeNY

SPORTIME
DANCE PROGRAM
The Dance Program at SPORTIME
offers a unique, non-competitive
environment, WITHOUT the pressures
of a required final recital. Our mission
is to help children learn and grow at
their own pace, and to encourage
them to achieve their personal dance
goals. Younger children experience an
introduction to dance through fun, creative, ageappropriate
activities. Older children enjoy learning
the newest moves and dancing to the latest music.
Our dedicated instructors use innovative and exciting
techniques to teach balance, rhythm, coordination and
movement. From beginner to advanced - FITNESS
AND FUN is what SPORTIME DANCE is all about!
TERESA ALIMO Dance Director
SPORTIME Lynbrook, 175 Merrick Rd, Lynbrook, NY 11563
P. 516/887-1330 F. 516/593-7462 www.SportimeNY.com/Lynbrook
Magical Moves w/ Mommy - Ages 2-3
This class is a fun and creative way for
parent and child to discover the world
of music, movement and body awareness,
through age-appropriate activities that will
stimulate and excite your child.
Broadway Babes - Pre-K
This movement class is designed to develop
coordination, rhythm and creativity, through
the use of props and unique musical tunes
that your child will love.
KinderBop Combo - Kindergarten
This class is divided into three sections:
Hip-Hop; Ballet; and Tap. (Ballet and tap
shoes are required for this class.)
TeenyBop Hip-Hop- Ages 6-7
This class is pure fun and energy, featuring
the latest dance moves to the coolest music.
CitiDance - Ages 8 & up
These classes combine MTV style, Hip-Hop
moves with a touch of jazz, for beginners
and advanced.
Call and sign up for
SPORTIME’s exciting DANCE
Program today!
516/887-1330
lynbrookdance@sportimeny.com
www. SportimeNY.com/Lynbrook
NON-
RECITAL
PROGRAM

SPORTIME DANCE APPLICATION SUMMER 2012
Student LAST Name Student FIRST Name
/ /
Date of Birth Age as of July 1st
Email Address - REQUIRED. (We will never disclose any email information.)
Address City State Zip
Home Phone Business Phone Cell Phone
Parent/Guardian LAST Name Parent/Guardian FIRST Name
PROGRAM INFORMATION AND COST
Eight-week summer session: $165
One class per week, beginning
July 9th, ending Aug. 31st.
Payment in full is due upon registration.
Complimentary membership is included
while the program is in session.
SPORTIME LYNBROOK Program Director: Teresa Alimo
175 Merrick Road, Lynbrook NY 11563 lynbrookdance@sportimeny.com
P. 516/887-1330 F. 516/593-7462 www.SportimeNY.com/lynbrook
STUDENT INFORMATION Please print clearly and legibly. One application per student please.
PAYMENT INFORMATION
MAGICAL MOVES W/MOMMY - 2&3 YRS
o Tuesday, 11:00 - 11:45
o Saturday, 11:00 - 11:45
BROADWAY BABES - 4 YEARS
o Tuesday, Noon - 12:45
KINDER COMBO - 5 YEARS
o Wednesday, 4:00 - 4:45
TEENYBOP HIP-HOP - 6 - 8 YEARS
o Wednesday, 5:00 - 5:45
CITIDANCE - 9 YEARS AND UP
o Thursday, 5:00 - 5:45
o Check Payment enclosed in the amount of: $_________
o Please charge the credit card listed below the full program cost, in the amount of: $_________
I understand that if I choose not to participate in the program, my payment may not be refunded.
o MasterCard o Visa o AMEX Exp. Date
PAYMENT TERMS, LIABILITY WAIVER AND ASSUMPTION OF RISK AND RELEASE
I understand that this application must be accompanied by the full program payment to confirm registration. I accept that enrollment in the program is for the
full session, that no refunds will be given for withdrawals after the session begins, and that Sportime does not guarantee make-ups for time missed by the student.
By signing below I agree that I/we will abide by all rules and regulations of SPORTIME (the "Club") which now exist or which may be hereafter adopted
or amended by the management of the Club. I further acknowledge and agree that there are certain inherent dangers in participating in dance and that the
Club shall not be liable for any personal injuries, property damage, or other loss sustained by me or my children in, on or about the premises of the Club, or
arising out of the use or intended use of any facilities, equipment or other property of the Club, whether or not said personal injuries, property damage, or other
loss sustained by the undersigned is the result of the negligence of the owners, agents or employees of the Club or the negligence of any other persons present
on the premises of the Club. The club reserves the right to cancel this contract at any time, at its sole discretion, and management's sole liability shall be to refund
any amounts previously paid on a pro-rata basis. SPORTIME retains the rights to any photographs/video taken at the facility for use in publicity or advertising.
PARENT’S/GUARDIAN’S SIGNATURE DATE STAFF SIGNATURE DATE
Office use only, please: Mem#_________ Pmt. Amt ______ $ p cc Date _____ Rec# _________ Rec. Init___