Application for Summer Workshop for Girls
This is an application form for parents of kids who would like to enroll in a Meditate and Create Performing Arts Workshop or Weekly Class or Camp. We offer after school workshops and camps that include a short meditation and creative writing section plus improvisation, some vocalization, possible songwriting and singing, and acting training all usually culminating in an end of the semester/camp show! The experience is not only creatively fulfilling but also mindful and healing! For more info on our classes: 

OUR CURRENT Summer CAMP Workshop Series in the BRS/ BJC hood: 
July 21 and 24 and then again from August 10-21! 
Girls Only Class (ages 11-17)  
Tues & Thurs: 1-4PM

📍 Where: Private Dance Studio near Boca Raton Synagogue (Address shared upon acceptance)

💰 Rate: $150/day if you sign up for both days on July 21st and 24th or $200/day if you only sign up for one day of camp.

Space is limited to keep the environment focused and supportive.

To Complete Registration: Fill out this app below and Send a Zelle payment of $100 non-refundable application fee to barbiekh@yahoo.com.
 You’ll receive an invoice receipt and class rules and address for Class!  

Camp Fees and Forms are due BEFORE First Day of Class begins.  


There are no Refunds. 
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Email *
My full name, my child's/childrens' full names, and ages and grade levels are: (write as many as you'd like)  *
My phone number on Whatsapp is: *
We are most interested in the following types of classes (check as many boxes as you like)  *
Required
We are looking for the following kind(s) of classes *
The best days and times for us to meet after school/camp are: (please note that classes are usually either 50 or 90 minutes long depending on availability and age and  skill level) *
My child has had some experience taking classes in the following: 
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My child's (or our family's) goal(s) for taking these classes is....Make the answer as long as you wish! *
Please mark the age(s) of your children you'd like to enroll in the workshop.   *
I have more questions and comments to share so I'll write them below...

PAGE TO STAGE PERFORMERS – PARTICIPANT WAIVER & RELEASE OF LIABILITY

By signing below, you acknowledge and agree to the following terms as a condition of your child's participation in Page to Stage Performers classes:

Assumption of Risk: I understand that participation in performing arts, drama games, vocal training, and movement activities involves inherent risks of minor physical injury (such as trips, slips, or falls). I voluntarily assume all risks associated with my child’s participation in these activities at the private studio location.

Medical Fitness & Emergency Treatment: I certify that my child is physically fit and capable of participating in these classes. In the event of a medical emergency, I authorize the staff of Page to Stage Performers to obtain necessary emergency medical treatment for my child if I cannot be reached immediately. Any medical expenses incurred will be my financial responsibility.

Release of Liability: I hereby release, waive, discharge, and hold harmless Page to Stage Performers, its director (Barbara Heller), instructors, staff, and the owners of the private dance studio premises from any and all liability, claims, actions, or demands arising out of any injury, loss, or damage sustained by my child during or as a result of the program.

Property Loss: I acknowledge that Page to Stage Performers is not responsible for any personal items that are lost, damaged, or stolen during class hours.

I have carefully read this Waiver and Release of Liability, fully understand its contents, and freely sign it of my own accord, by clicking the YES below.

*
By filling out this form I acknowledge that my child may have a photo or video taken of their performance/class work that may be used in marketing materials such as a photo or video for Page to Stage Performers on the website or in a flyer at a future date.  *
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