Ms. Davis's Parent Information Request Form

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Hello! It's the beginning of the year, and it's time to get to know each other. Students received a syllabus and some parent signature forms during the first week of school. Parents, you can choose to fill this out on paper or online.

What class period does your student have Ms. Davis? *

1: Oral Comm

2: Theatre Dance I

3: Theatre Dance I

4: Theatre Dance II

6: Theatre Dance I

7: Theatre Dance I

What is the name of your student? *

What is a parent/guardian's name? *

What is the parent/guardian's email address? *

What is the parent/guardian's phone number? *

Please provide numbers in the case of an emergency.

Please check each box to acknowledge that you have checked the availability of these dates for your student to participate. *

The workshops are lead by student volunteers, so students are not required to attend; however, the dress rehearsal and recital are required. Please put these in your calendars!

December 6, 2014 – Fall Elementary Workshop at Rogers High School

April 18, 2015 – Spring Elementary Workshop at Rogers High School

April 25, 2015 – Dress Rehearsal at Rogers High School

April 26, 2015 – Dance Production at Rogers High School

Required

What are your goals for your student in Theatre Dance?

Are you interested in volunteering with Theatre Dance this year?

Check any that apply.

Working backstage at dance recital

Selling tickets at dance recital

Working elementary school workshop

Teaching a style of dance

Media Consent: Please visit our online profiles to see how RPS Theatre Dance keeps students, family, friends and others informed on what we do in class! rpstheatredance.blogspot.com www.instagram.com/rpstheatredance www.twitter.com/rpstheatredance http://www.youtube.com/rpsdance *

By checking this box, I hereby consent to the use of quotes and the taking of photographs or video of my student. I also grant the Rogers Public Schools Theatre Dance program to post said quotes, pictures, or videos to the social networking sites listed above. I understand that these are for educational purposes.

I do not give consent.

Required

Google Consent: In Theatre Dance, students will use technology to create portfolios and assessments. These assessments are created and stored in Google drive, which links to all of Google’s online resources including Gmail, YouTube, etc. These resources are free and a great addition to the classroom. *

I hereby consent my student to create and maintain a Google account for class.

I do not consent. My child can use a personal jump drive instead.

Required

Physical Activity Consent: My student is physically able to undergo physical activity during Theatre Dance class period. S/he has my permission to participate in the dance class and all of its offerings at Rogers Public Schools. If for any reason s/he is physically unable to participate in any dance classes, I will contact the dance teacher immediately. *

Yes, my student is physically able to participate.

No, my student is not physically able to participate.

Required

Are there any health concerns that you would like for me to know about?

By typing your name below, you are acknowledging that you have read and agree to the guidelines in the syllabus. *

Please type your name in place of a signature.

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