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Clements Stars Dance Team Presents...

join us this summer for a captivating dance experience!


Designedforages:June4,2012
513yearsoldClementsHighSchoolSpecialperformance@4:00pm
PLEASEhaveownsacklunch9:00am4:00onJune4thforparents&friends!
andabottleofwater!**checkinbeginsat8:30**

Costforthecamp:

$35(addtlsiblings$25each)Registrationdates:
FBISDemployees/EARLYBIRDS!!!EARLYMay431,2012discountedrates!
$45(addtlsiblings$35each)June1June4,2012standardratesapply!
standardrate

Registrationformsmaybesentdirectly:ClementsDanceDepartment
Attn:MichelleBarth
4200ElkinsDrive
SugarLand,TX77479
Pleasemakecheckpayableto:CLEMENTSACTIVITYFUND&includechildsnameinthememosectionofthecheck.

Ifyouhaveanyquestionsorconcerns,pleasecall281.634.2204oremailmichelle.barth@fortbend.k12.tx.usatanytime!Fee
includescamptshirt&allactivities!Registrationatthedoordoesnotguaranteeatshirt.Dresscomfortablywithshorts,
leggings,orotherdancewearattirewithtennisshoes.
Norefundswillbegivenforcancellationsornoshows.

(cutalonglineandreturnwithpayment)

Name:________________________________________________Grade:__________Phone:___________________________

Parent/Guardiansname:____________________________________________________Cell:___________________________

Address:________________________________________________________City:____________________Zip:_____________

email:_________________________________________________Allergies:__________________________________________

Pleasecircletshirtsize(s)anddenotequantities:EMERGENCYCONTACT#____________________________________

YOUTH

___S

___M

___L

___XL

ADULT

___S

___M

___L

___XL

Igivemychild,__________________________________,permissiontoparticipateintheClementsStarsDanceTeamDanceCamp.IwillnotholdClements
HighSchoolliableforanyaccidentorinjurythatmayoccurduringthecamp.Intheeventofanemergency&ifIamunabletobereachedattheabove
phonenumbers,IherebyauthorizeClementsHighSchoolfaculty/stafftoseekmedicalattentionformychild.

(HealthInsuranceprovider:______________________________Policy/Group#___________________________)

Parent/Guardianssignature:_______________________________________________________

FortBendIndependentSchoolDistricthasapprovedthedistributionofnonschoolliteratureatcampusesinaccordancewithproceduresestablishedwiththe
campusprincipal.ThisorganizationanditsactivitiesarenotrelatedtoorsponsoredbyFortBendISD.

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