Flamenco Kids Camp 2017 Registration Packet June 5-16, 2017 Flamenco Kids Camp is the youth component of Festival Flamenco Internacional de Alburquerque sponsored by the National Institute of Flamenco. This two-week day camp introduces children ages 6-12 to the full range of flamenco arts and culture. Flamenco Kids Camp is a fun, creative outlet featuring classes in dance, guitar, cajón (percussion), cante (singing), Spanish language, and literacy. Included with the camp tuition, students receive a Kids Camp T-Shirt, tote bag, and a ticket to attend a world-class flamenco performance held during this year’s 30th Anniversary Festival Flamenco. The camp concludes with a free performance for friends and family at the historic Kimo Theater, where students demonstrate all they have learned during the course of the camp. Remember that space is limited and registration is taken on a first-come/firstserved basis! Flamenco Kids Camp is held at the Conservatory of Flamenco Arts located at: 1620 Central Avenue SE Albuquerque, NM 87106 Instructions for Completion of Registration Form: Applicants must complete the attached registration form in its entirety along with parent/guardian signature(s). All registration forms are due by Friday, May 19, 2017. NO EXCEPTIONS. You can mail or hand-deliver paper registration forms along with payment to: The National Institute of Flamenco 1620 Central Avenue SE Albuquerque, NM 87106 For more information or if you have questions, please call the National Institute of Flamenco at (505) 242-7600 or e-mail: [email protected] or [email protected] 1 Flamenco Kids Camp 2017 - Participant Information Flamenco Kids Camp 2017 Schedule June 5 – 16, 2017 Camp meets Monday through Friday, 9:00-2:00PM daily; Drop-Off at 8:45am daily Tuition Rates $500 – Flamenco Kids Camp 2017 Tuition $250 – Current Conservatory of Flamenco Arts Students receive 50% off regular tuition plus 10 classes toward level advancement! Enter promo code kidscamp2017 during check out. *A limited number of scholarships are available for families with financial need. Please inquire. Flamenco Kids Camp 2017 Orientation There will be a required orientation meeting for parents on the Saturday prior to the start of Camp (Saturday, June 3rd). Details will be mailed and/or e-mailed home to the parents of all confirmed registered campers. If you cannot attend the orientation on June 3rd, please plan to meet at 8:30am on the first day of camp for a brief orientation. First day Flamenco Kids Camp: • • • • All parents must walk their child in on the first day – meet your child’s teacher! Pick up your child’s Flamenco Kids Camp T-Shirt and tote bag. Pick up a copy of the calendar of camp events, important dates, and performances. Students bring their supplies for literacy class, labeled with their name (these can be “recycled” supplies). Students must bring the following to Kids Camp on a DAILY basis: • • • • • • • • • All parents must come in to drop-off and pick-up their children daily. A sack lunch (something students can carry). A water bottle labeled with student’s name. Kids Camp T-Shirt (this must be worn EVERY DAY). Flamenco shoes (or hard-soled dress shoes). Tennis shoes or good walking shoes and comfortable clothing. Sunscreen (to be applied before student comes to camp). Girls: Flamenco skirt or long skirt and hair pulled back. Boys: Long pants. Literacy Class Supply List (Keep in mind, these supplies do not need to be new) • • • • Three-ring Binder (about 1”) 5 page protectors, 5 subject dividers Pencil bag/small box for crayons, colored pencils, or markers Pencils PLEASE KEEP PAGES 1-2 FOR YOUR INFORMATION. PLEASE DETACH AND SUBMIT THE REGISTRAITON FORMS ON PAGES 3-7. 2 Flamenco Kids Camp 2017 Registration Form June 5-16, 2017 Completed registration packets must be submitted by Friday, May 19, 2017. NO EXCEPTIONS. • $500.00 Flamenco Kids Camp 2017 Tuition; $250.00 for current Conservatory of Flamenco Arts students. Checks payable to National Institute of Flamenco. Credit card and cash payment options available. • Flamenco Kids Camp 2017 Registration Form • Publicity Release Form • Permission for Participation/Authorization for Medical Services Form • Flamenco Kids Camp T-Shirt size Form ______ Conservatory Student (ages 6-12) ______ Non-Conservatory Student (ages 6-12) Participant Information Child’s Full Name: _______________________________________________________________________ Parent/Guardian names: ___________________________________________________________________ Child’s current age: ___________ Child’s date of birth: __________________________________________ Home address: ___________________________________________________________________________ City: __________________________________________________ State: _______ Zip: ________________ Home phone: _________________________________________________________ E-Mail:______________________________________________________________ Parent 1’s work phone/extension: _________________________________________ Parent 2’s work phone/extension: _________________________________________ Where did you hear about Kids Camp? _______________________________________________________ Name of child’s school: ____________________________________________________________________ Emergency Contact Information If we have to contact a parent during Kids Camp, whom shall we call? At what number can they be reached? Name: _____________________________________________________ Phone: ______________________ Emergency Contact Information (Please list someone other than a parent) Name: _____________________________________________________ Phone: ______________________ Relationship: ____________________________________________________________________________ Is anyone other than you authorized to pick your child up from Kids Camp? ______ No _____Yes If yes, list name(s): _______________________________________________________________________ Parent/Guardian Signature________________________________________________________ Date____________ 3 Flamenco Kids Camp 2017 National Institute of Flamenco (NIF) Permission for Participation/Physical Activity Parent Permission Slip I, ________________________________, give permission for my child ______________________ (Parent Name) (Student Name) to participate in all activities for Flamenco Kids Camp 2017 between the dates of June 5-16, 2017. An off-site activity will take place as described below: June 16, 2017 Flamenco Kids Camp 2017 performance at the Kimo Theater in Albuquerque, NM Estimated Departure – 12:00pm; Parents will pick-up after the performance Transportation to destination by School Bus/Van The parent/guardian recognizes that activities and/or trips involve some degree of risk and that the National Institute of Flamenco cannot guarantee the safety of participants. Knowing this risk, the parent/guardian grants permission for the student to participate. My signature evidences that I accept general liability for the participation of my child in the activity identified above and that I agree to indemnify and hold harmless the National Institute of Flamenco, its teachers, its sponsors, its governing board, and other participating agents, either jointly or severally, from and against any and all claims, injuries, damages, losses, costs, or causes of action that may arise in connection with this activity. I understand that a student code of conduct will apply during Flamenco Kids Camp 2017. All Flamenco Kids Camp students and staff who are participating in activities or field trips are expected display the virtues of respect, citizenship, caring, trustworthiness, fairness, and responsibility. Students are expected to maintain the highest standard of behavior at all times. Failure to abide by these guidelines may result in further disciplinary action to include dismissal from the activity or suspension from Flamenco Kids Camp 2017. Additionally, I give permission for my daughter/son to be transported to and from all Flamenco Kids Camp 2017 activities. Students will walk (with adult supervision) to and from select activities. A school bus/van will be utilized for Flamenco Kids Camp 2017 transportation. I have read and give my consent to the above statements: ________________________________________________________________________________ Parent/Guardian Signature ________________ Date 4 Flamenco Kids Camp 2017 National Institute of Flamenco (NIF) Authorization for Medical Services Form – Part I The National Institute of Flamenco (NIF) wishes to avoid difficulties in obtaining medical services for students who may become ill or injured during NIF-sponsored activities or field trips. As the parent/guardian of a student participating in a NIF-sponsored activity, it is necessary that you consent, in advance, to hospitalization, medical attention, and surgery for your child in case an emergency occurs. You must provide direction if no consent is given. In the event of illness or injury, a reasonable effort will be made to contact you to obtain consent in advance of medical services being given. If we are unable to contact you, the coordinator will consent to such services for your child by acting in your behalf based on written advance authorization. That authorization is in the consent form below. Selection of a doctor or hospital will be made on the basis of family preference, if known. If family preference is unknown, the student will be taken to the closest hospital or one consistent with the existing circumstances. By signing below the parent/guardian authorizes emergency medical treatment and/or hospitalization deemed necessary by emergency response or medical personnel. • If my child has special or medical needs or routinely must take medication, I will complete Part II of the form on page 6. • If my child requires prescription medication during the course of the Camp, I will advise the Kids Camp Coordinator in advance and provide her with a doctor’s order or prescription. • Special arrangements for the transporting of student medications may be required. Authorization for Medical Services I, the parent/guardian of ________________________________ have read the above and hereby designate the sponsor of the field trip or activity to act in my behalf in the event of a medical emergency. He/She may authorize such hospitalization, medical attention, and surgery as may be required in an emergency because of illness or injuries sustained by my child while participating in NIF-sponsored activities. I, the parent/guardian, hereby assume financial responsibility for transport (ambulance) to hospital, hospitalization, medical attention, and surgery provided. _____________________________________________ ________________ Parent/Guardian Signature Date IMPORTANT: If you do not give consent for the authorization of medical services, DO NOT sign above. Please read and sign the statement below. ☐ Limited or No Medical Services Authorized If participation in field trips or activities is permitted, but medical services are not authorized: 1. PLEASE CHECK THE BOX ABOVE 2. Please attach a written statement of procedures to be followed if your child is injured or ill during the trip. This form must be in the possession of the sponsor at all times during all trips. I have read and give my consent to the above statements: _____________________________________________ ________________ Parent/Guardian Signature Date 5 Flamenco Kids Camp 2017 National Institute of Flamenco (NIF) Authorization for Medical Services Form – Part II THIS FORM MUST BE IN THE POSSESSION OF THE SPONSOR AT ALL TIMES DURING ALL TRIPS. SERVICES FOR ILL OR INJURED STUDENTS, WHO ROUTINELY MUST TAKE MEDICATIONS, AND WHO HAVE MEDICAL CONCERNS THAT MAY REQUIRE TREATMENT WHILE PARTICIPATING IN KIDS CAMP: 1. List any medical concerns that may affect your child’s participation in Flamenco Kids Camp 2017 (voluntary disclosure): ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 2. Known Allergies to Medications or Foods: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 3. List any current medications the student is taking: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 4. Prescription medications that need to be taken or administered to student during Flamenco Kids Camp 2017 hours of operation (June 5-16, 2017, Mon-Fri, 9AM-2PM): ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ 5. Prescription medications for emergencies. My authorization form (Part I – page 6) has been completed and attached: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ _____________________________________________ ________________ Parent/Guardian Signature Date 6 Flamenco Kids Camp 2017 Photo/Video Consent and Release Form Without expectation of compensation or other remuneration, now or in the future, I, (the parent/legal guardian) hereby give my consent to the National Institute of Flamenco, its affiliates and agents, to use my child’s, ________________________________________, image and Child Name likeness and/or any interview statements from my child in its publications, advertising or other media activities (including the Internet). This consent includes, but is not limited to: (a) Permission to interview, film, photograph, tape, or otherwise make a video reproduction of my child and/or record his/her voice; (b) Permission to use my child’s name; and (c) Permission to use quotes from the interview(s) (or excerpts of such quotes), the film, photograph(s), tape(s) or reproduction(s) of my child, and/or recording of my child’s voice, in part or in whole, in its publications, in newspapers, magazines and other print media, on television, radio and electronic media (including the Internet), in theatrical media and/or in mailings for educational and awareness. This consent is given in perpetuity, and does not require prior approval by me. Name of Student:__________________________________________________________ Name of Parent or Legal Guardian: ___________________________________________ Signature: Address: Date: National Institute of Flamenco 1620 Central Ave SE Albuquerque, NM 87106 (505) 242-7600 www. nifnm.org [email protected] 7 Flamenco Kids Camp 2017 T-Shirt size Form Student name: ________________________________________________________ Please circle your child’s shirt size and include this with your payment and registration form. Child Sizes Adult Sizes XS S M L S M L XL XXL Office Use: Red Group Blue Group Yellow Group 8
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