Ragin' Jazz Dance Team College Prep Clinic

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Ragin’ Jazz Dance Team College Prep Clinic Sunday November 22, 2015

E. K. Long Gymnasium

12:00 p.m. – 3:00 p.m.

500 East St. Mary Blvd.

(Check in opens at 11:30 a.m.)

$35 High School Sophomores, Juniors & Seniors $10 Current UL students with current Cajun Card (Checks Only, payable to UL Lafayette Foundation, write SPIRIT SQUADS in the memo)

Name: __________________________________________ Birthdate: _____________ Age: ______ Email Address (your email that you check regularly) ________________________________________________ Cell Phone: _____________________ Attending UL in Fall 2016:

YES

NO

UNDECIDED

Previous Dance Experience: ___________________________________________________________ STATEMENT OF UNDERSTANDING WAIVER The  undersigned  is  aware  of  and  acknowledges  the  risks  associated  with  participation  in  dance  team   activities,  including  but  not  without  limitation,  the  risk  of  catastrophic  injury,  paralysis  and  even  death.     Nevertheless,  it  is  the  undersigned’s  desire  to  participate  in  dance  team  at  UL  Lafayette.    The  undersigned   assumes  all  risk  of  injury  associated  with  said  participation  and  specifically  agrees  to  indemnify  and  hold   free  and  harmless  the  University  of  Louisiana  at  Lafayette,  its  agents  and  employees,  including  without   limitation  the  Ragin’  Jazz  Dance  Team,  coaches,  staff,  spirit  coordinator  and  all  other  members  of  the   department  of  athletics  staff,  from  any  and  all  claims  or  causes  of  action  arising  out  of  his/her  participation   in  dance  team  activities  at  UL  Lafayette,  no  matter  what  the  cause.    The  undersigned  further  acknowledges   that  and  certifies  that  he/she  is  at  least  18  years  of  age.     Signature:    ______________________________________________________________   Date:    ________________________________     If  under  18,  this  form  MUST  be  signed  by  a  parent  or  legal  guardian  prior  to  participation,  NO  EXCEPTIONS.     Signature:    ______________________________________________________________   Date:    ________________________________       The  clinic  will  focus  on  jazz,  pom  and  hip  hop,  covering  the  basics  and  advanced  skills,  as  well  as   proper  dance  technique.    Wear  proper  attire,  dance  shorts/leggings,  sports  bra/dance  top  and  bring   jazz    and  tennis  shoes.    Be  sure  to  bring  your  own  bottle  of  water/sports  drink.    Email   [email protected]  to  reserve  your  spot.    Bring  this  form,  fee,  waiver  and  front/back  copy  of   your  insurance  card  to  clinic  check  in.   RAGIN’ CAJUNS SPIRIT SQUAD OFFICE 337-482-5108 Student Union Room 157